Clinical characteristics of pediatric HIV-1 patients treated with first-line antiretroviral therapy in Vietnam: a nested case-control study.
OBJECTIVE
Over the past decades, Vietnam has made great strides in reducing the rate of mortality in HIV-related deaths, due to increased access of antiretroviral therapy (ART); however, given the significantly high level of treatment failure (TF), it is essential to identify markers that describe the failure of ART in HIV-1 infected children.


METHODS
A nested case-control study was conducted with clinical data collected from 101 HIV-infected children [26 TF and 75 treatment success (TS)] at National Hospital of Pediatrics, Vietnam (2008-2012).


RESULTS
The results showed that certain factors including height, weight, vaccination with Hepatitis B, and platelet were significantly different between TF and TS before starting the treatment. In addition, age to start the treatment, CD4 percentage, and opportunistic infection were found to significantly predict treatment outcome most frequently, implying the importance of clinical markers in the treatment response by Cox regression analysis.


CONCLUSIONS
There is an inherent complexity within clinical markers that is challenging to determine HIV-pediatric failure and further research is needed to build a complete picture to guide clinical, evidence-based practice.
Hanoi University of Public Health, Hanoi, Vietnam.
Minh Diem
MD
Dang
National Hospital of Acupuncture, Hanoi, Vietnam.
Duc Minh
DM
Nguyen
Hanoi University of Public Health, Hanoi, Vietnam.
Huu Bich
HB
Tran
Vietnam National Hospital of Pediatrics, Hanoi, Vietnam.
Viet Hung
VH
Pham
University of Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Daryl
D
Spak
University of Washington, Seattle, Washington, USA.
Linh Chi
LC
Pham
Hanoi University of Public Health, Hanoi, Vietnam.
Thi Quynh
TQ
Phan
Hanoi University of Public Health, Hanoi, Vietnam.
Thi Thanh
TT
Dinh
Hanoi University of Public Health, Hanoi, Vietnam.
Thi Kim Anh
TK
Le
National Hospital of Acupuncture, Hanoi, Vietnam.
Van Lam
VL
Nguyen
National Hospital of Acupuncture, Hanoi, Vietnam.
Thanh Hai
TH
Le
Viet Duc Hospital, Hanoi, Vietnam.
Son Ngoc
SN
Hoang
Hanoi University of Public Health, Hanoi, Vietnam. dvpl@huph.edu.vn.
Vu Phuong Linh
VP
Dang
D017088:AIDS-Related Opportunistic Infections; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D008297:Male; D010976:Platelet Count; D012189:Retrospective Studies; D017211:Treatment Failure; D014744:Vietnam
D019380:Anti-HIV Agents; D017325:Hepatitis B Vaccines
ART; HIV-1; Pediatric; Treatment failure