title: Outcome of highly active antiretroviral therapy in HIV-infected Indian children.
abstract: BACKGROUND
  With the advent of highly active antiretroviral therapy (HAART), HIV infection has become a chronic condition in children with improved survival and quality of life. Reports on long term effectiveness of non-nucleoside reverse transcriptase inhibitor based HAART in HIV-infected children in developing countries are limited.
  
  
  METHODS
  A chart review was conducted and children who received at least six months of HAART between 2004-2011 at All India Institute of Medical Sciences (AIIMS), Delhi were included. The clinical, immunological and virological responses to HAART were documented. Factors predicting non-adherence and non-response to treatment were described.
  
  
  RESULTS
  One seventy five children (boys: 74.9%) were included in the study, with a median follow up of 43 (IQR: 17, 68) months. The median age at diagnosis was 119 (IQR: 75, 156) months. The median CD4 count at start of HAART was 340 cells/μL (IQR: 185,704), which increased to 924 cells/μL (IQR: 591,1278) at 48 months after HAART and plateaued at 749 (IQR: 542,1056) cells/ μL after 90 months of therapy. The weight for age (WAZ) and height for age (HAZ) z score both showed improvement with time after HAART initiation [baseline: WAZ -2.8 (IQR: -4,-1.6), HAZ -2.1 (IQR: -3.4,-0.69); at 42 months of therapy: WAZ -1.2 (IQR: -2.1, 0.01), HAZ -0.75(IQR: -1.6,-0.37)]. Adverse events were reported in 21 (12%) children. Non-adherence to therapy, treatment failure and death were noted in 35 (20%), 9 (5.1%) and 6 (3.4%) children respectively.
  
  
  CONCLUSIONS
  Our experience shows that HAART in HIV-infected children is effective, safe and is associated with good immunological and virological response as well as improvement in growth parameters.
authors.affiliation: Departments of Pediatrics and Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. aparna.sinha.deb@gmail.com.
authors.forename: Aparna
authors.initials: A
authors.lastname: Mukherjee
authors.affiliation: Departments of Pediatrics and Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. dr.nipam@gmail.com.
authors.forename: Nipam
authors.initials: N
authors.lastname: Shah
authors.affiliation: Departments of Pediatrics and Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. ravinder.rathore.singh@gmail.com.
authors.forename: Ravinder
authors.initials: R
authors.lastname: Singh
authors.affiliation: Departments of Pediatrics and Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. mvajpayee@gmail.com.
authors.forename: Madhu
authors.initials: M
authors.lastname: Vajpayee
authors.affiliation: Departments of Pediatrics and Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. skkabra@hotmail.com.
authors.forename: Sushil K
authors.initials: SK
authors.lastname: Kabra
authors.affiliation: Departments of Pediatrics and Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. rakesh_lodha@hotmail.com.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Lodha
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001835:Body Weight; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007194:India; D008297:Male; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors