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Five-year follow-up of children with perinatal HIV-1 infection receiving early highly active antiretroviral therapy

BACKGROUND: Early highly active antiretroviral therapy (HAART), started within the first months of age, has been proven to be the optimal strategy to prevent immunological and clinical deterioration in perinatally HIV-infected children. Nevertheless, data about long-term follow-up of early treated c...

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Autores principales: Chiappini, Elena, Galli, Luisa, Tovo, Pier-Angelo, Gabiano, Clara, Lisi, Catiuscia, Bernardi, Stefania, Viganò, Alessandra, Guarino, Alfredo, Giaquinto, Carlo, Esposito, Susanna, Badolato, Raffaele, Di Bari, Cesare, Rosso, Raffaella, Genovese, Orazio, Masi, Massimo, Mazza, Antonio, de Martino, Maurizio
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2753343/
https://www.ncbi.nlm.nih.gov/pubmed/19709432
http://dx.doi.org/10.1186/1471-2334-9-140
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author Chiappini, Elena
Galli, Luisa
Tovo, Pier-Angelo
Gabiano, Clara
Lisi, Catiuscia
Bernardi, Stefania
Viganò, Alessandra
Guarino, Alfredo
Giaquinto, Carlo
Esposito, Susanna
Badolato, Raffaele
Di Bari, Cesare
Rosso, Raffaella
Genovese, Orazio
Masi, Massimo
Mazza, Antonio
de Martino, Maurizio
author_facet Chiappini, Elena
Galli, Luisa
Tovo, Pier-Angelo
Gabiano, Clara
Lisi, Catiuscia
Bernardi, Stefania
Viganò, Alessandra
Guarino, Alfredo
Giaquinto, Carlo
Esposito, Susanna
Badolato, Raffaele
Di Bari, Cesare
Rosso, Raffaella
Genovese, Orazio
Masi, Massimo
Mazza, Antonio
de Martino, Maurizio
author_sort Chiappini, Elena
collection PubMed
description BACKGROUND: Early highly active antiretroviral therapy (HAART), started within the first months of age, has been proven to be the optimal strategy to prevent immunological and clinical deterioration in perinatally HIV-infected children. Nevertheless, data about long-term follow-up of early treated children are lacking. METHODS: We report data from 40 perinatally HIV-infected-children receiving early HAART, with a median follow-up period of 5.96 years (interquartile range [IQR]:4.21–7.62). Children were enrolled at birth in the Italian Register for HIV Infection in Children. Comparison with 91 infected children born in the same period, followed-up from birth, and receiving deferred treatment was also provided. RESULTS: Nineteen children (47.5%) were still receiving their first HAART regimen at last follow-up. In the remaining children the first regimen was discontinued, after a median period of 3.77 years (IQR: 1.71–5.71) because of viral failure (8 cases), liver toxicity (1 case), structured therapy interruption (3 cases), or simplification/switch to a PI-sparing regimen (9 cases). Thirty-nine (97.5%) children showed CD4(+ )T-lymphocyte values>25%, and undetectable viral load was reached in 31 (77.5%) children at last visit. Early treated children displayed significantly lower viral load than not-early treated children, until 6 years of age, and higher median CD4(+ )T-lymphocyte percentages until 4 years of age. Twenty-seven (29.7%) not-early treated vs. 0/40 early treated children were in clinical category C at last follow-up (P < 0.0001). CONCLUSION: Our findings suggest that clinical, virologic and immunological advantages from early-HAART are long-lasting. Recommendations indicating the long-term management of early treated children are needed.
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spelling pubmed-27533432009-09-29 Five-year follow-up of children with perinatal HIV-1 infection receiving early highly active antiretroviral therapy Chiappini, Elena Galli, Luisa Tovo, Pier-Angelo Gabiano, Clara Lisi, Catiuscia Bernardi, Stefania Viganò, Alessandra Guarino, Alfredo Giaquinto, Carlo Esposito, Susanna Badolato, Raffaele Di Bari, Cesare Rosso, Raffaella Genovese, Orazio Masi, Massimo Mazza, Antonio de Martino, Maurizio BMC Infect Dis Research Article BACKGROUND: Early highly active antiretroviral therapy (HAART), started within the first months of age, has been proven to be the optimal strategy to prevent immunological and clinical deterioration in perinatally HIV-infected children. Nevertheless, data about long-term follow-up of early treated children are lacking. METHODS: We report data from 40 perinatally HIV-infected-children receiving early HAART, with a median follow-up period of 5.96 years (interquartile range [IQR]:4.21–7.62). Children were enrolled at birth in the Italian Register for HIV Infection in Children. Comparison with 91 infected children born in the same period, followed-up from birth, and receiving deferred treatment was also provided. RESULTS: Nineteen children (47.5%) were still receiving their first HAART regimen at last follow-up. In the remaining children the first regimen was discontinued, after a median period of 3.77 years (IQR: 1.71–5.71) because of viral failure (8 cases), liver toxicity (1 case), structured therapy interruption (3 cases), or simplification/switch to a PI-sparing regimen (9 cases). Thirty-nine (97.5%) children showed CD4(+ )T-lymphocyte values>25%, and undetectable viral load was reached in 31 (77.5%) children at last visit. Early treated children displayed significantly lower viral load than not-early treated children, until 6 years of age, and higher median CD4(+ )T-lymphocyte percentages until 4 years of age. Twenty-seven (29.7%) not-early treated vs. 0/40 early treated children were in clinical category C at last follow-up (P < 0.0001). CONCLUSION: Our findings suggest that clinical, virologic and immunological advantages from early-HAART are long-lasting. Recommendations indicating the long-term management of early treated children are needed. BioMed Central 2009-08-26 /pmc/articles/PMC2753343/ /pubmed/19709432 http://dx.doi.org/10.1186/1471-2334-9-140 Text en Copyright ©2009 Chiappini et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Chiappini, Elena
Galli, Luisa
Tovo, Pier-Angelo
Gabiano, Clara
Lisi, Catiuscia
Bernardi, Stefania
Viganò, Alessandra
Guarino, Alfredo
Giaquinto, Carlo
Esposito, Susanna
Badolato, Raffaele
Di Bari, Cesare
Rosso, Raffaella
Genovese, Orazio
Masi, Massimo
Mazza, Antonio
de Martino, Maurizio
Five-year follow-up of children with perinatal HIV-1 infection receiving early highly active antiretroviral therapy
title Five-year follow-up of children with perinatal HIV-1 infection receiving early highly active antiretroviral therapy
title_full Five-year follow-up of children with perinatal HIV-1 infection receiving early highly active antiretroviral therapy
title_fullStr Five-year follow-up of children with perinatal HIV-1 infection receiving early highly active antiretroviral therapy
title_full_unstemmed Five-year follow-up of children with perinatal HIV-1 infection receiving early highly active antiretroviral therapy
title_short Five-year follow-up of children with perinatal HIV-1 infection receiving early highly active antiretroviral therapy
title_sort five-year follow-up of children with perinatal hiv-1 infection receiving early highly active antiretroviral therapy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2753343/
https://www.ncbi.nlm.nih.gov/pubmed/19709432
http://dx.doi.org/10.1186/1471-2334-9-140
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