title: Nine-year follow-up of HIV-infected Romanian children and adolescents receiving lopinavir/ritonavir-containing highly active antiretroviral therapy.
abstract: BACKGROUND
  Many Romanian children were infected nosocomially with human immunodeficiency virus (HIV) in the late 1980s. The Romanian-American Children's Center of Excellence in Constanţa continues to follow approximately 450 of these patients. In 2001, 414 of these patients were initiated on triple therapy including lopinavir/ritonavir. Data from this cohort treated through August 2006 were published in April 2007 demonstrating that the treatment was well tolerated, with 337 children (81%) remaining on therapy after a median duration of >4 years. The current article describes the results of continued analysis of this cohort through end 2010. The objective of the study was to determine the long-term clinical outcomes of children and adolescents commenced on antiretroviral therapy (ART) including lopinavir/ritonavir.
  
  
  METHODS
  Data were extracted retrospectively from the charts of the 336 patients remaining on lopinavir/ritonavir in August 2006. The following outcomes were analyzed: mortality, current patient status, viral load (VL), CD4 counts and reasons for discontinuation of lopinavir/ritonavir.
  
  
  RESULTS
  The median age at initiation of lopinavir/ritonavir was 14.0 years (range 5.4 to 20.0 years). The median time on lopinavir/ritonavir treatment was 7.5 years (interquartile range 5.7 to 8.6 years). Overall mortality was 13.5%. Of the original 414 patients started on lopinavir/ritonavir in 2001, 199 (48.1%) remained on this therapy at the end of 2010 and of these 63.8% had undetectable viral load.
  
  
  CONCLUSIONS
  Despite initial suboptimal ART, a significant proportion of patients subsequently treated with a lopinavir/ritonavir based regimen remained on this therapy for up to nine years.
authors.affiliation: MB, ChB, PhD, Baylor College of Medicine International Pediatric AIDS Initiative, Texas Children's Hospital, Houston, Texas, USA.
authors.forename: Richard S B
authors.initials: RS
authors.lastname: Wanless
authors.affiliation: MD, PhD, Ovidius University of Constanţa; Clinical Hospital of Infectious Diseases, Constanţa, Romania.
authors.forename: Sorin
authors.initials: S
authors.lastname: Rugină
authors.affiliation: MD, PhD, Carol Davila University of Medicine and Pharmacy, Bucharest; Ştefan S. Nicolau Institute of Virology, Bucharest, Romania.
authors.forename: Simona Maria
authors.initials: SM
authors.lastname: Ruţă
authors.affiliation: MD, PhD, Ovidius University of Constanţa; Clinical Hospital of Infectious Diseases, Constanţa, Romania.
authors.forename: Irina-Magdalena
authors.initials: IM
authors.lastname: Dumitru
authors.affiliation: MD, Clinical Hospital of Infectious Diseases, Constanţa, Romania.
authors.forename: Roxana Carmen
authors.initials: RC
authors.lastname: Cernat
authors.affiliation: MD, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Heidi L
authors.initials: HL
authors.lastname: Schwarzwald
authors.affiliation: RN, MSN, MPH, Baylor College of Medicine International Pediatric AIDS Initiative, Houston, Texas, USA.
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Calles
authors.affiliation: MD, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Gordon E
authors.initials: GE
authors.lastname: Schutze
authors.affiliation: MA, Baylor-Black Sea Foundation, Constanţa, Romania.
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Schweitzer
authors.affiliation: MS Baylor College of Medicine International Pediatric AIDS Initiative, Texas Children's Hospital, Houston, Texas, USA.
authors.forename: Heather R
authors.initials: HR
authors.lastname: Draper
authors.affiliation: MD Baylor College of Medicine International Pediatric AIDS Initiative, Texas Children's Hospital, Houston, Texas, USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Kline
keywords: HIV/AIDS; antiretroviral therapy; lopinavir/ritonavir