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Outcome of highly active antiretroviral therapy in HIV- infected Indian children

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...

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Autores principales: Mukherjee, Aparna, Shah, Nipam, Singh, Ravinder, Vajpayee, Madhu, Kabra, Sushil K, Lodha, Rakesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4297378/
https://www.ncbi.nlm.nih.gov/pubmed/25539905
http://dx.doi.org/10.1186/s12879-014-0701-2
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author Mukherjee, Aparna
Shah, Nipam
Singh, Ravinder
Vajpayee, Madhu
Kabra, Sushil K
Lodha, Rakesh
author_facet Mukherjee, Aparna
Shah, Nipam
Singh, Ravinder
Vajpayee, Madhu
Kabra, Sushil K
Lodha, Rakesh
author_sort Mukherjee, Aparna
collection PubMed
description 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-014-0701-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-42973782015-01-18 Outcome of highly active antiretroviral therapy in HIV- infected Indian children Mukherjee, Aparna Shah, Nipam Singh, Ravinder Vajpayee, Madhu Kabra, Sushil K Lodha, Rakesh BMC Infect Dis Research Article 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-014-0701-2) contains supplementary material, which is available to authorized users. BioMed Central 2014-12-24 /pmc/articles/PMC4297378/ /pubmed/25539905 http://dx.doi.org/10.1186/s12879-014-0701-2 Text en © Mukherjee et al.; licensee BioMed Central. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Mukherjee, Aparna
Shah, Nipam
Singh, Ravinder
Vajpayee, Madhu
Kabra, Sushil K
Lodha, Rakesh
Outcome of highly active antiretroviral therapy in HIV- infected Indian children
title Outcome of highly active antiretroviral therapy in HIV- infected Indian children
title_full Outcome of highly active antiretroviral therapy in HIV- infected Indian children
title_fullStr Outcome of highly active antiretroviral therapy in HIV- infected Indian children
title_full_unstemmed Outcome of highly active antiretroviral therapy in HIV- infected Indian children
title_short Outcome of highly active antiretroviral therapy in HIV- infected Indian children
title_sort outcome of highly active antiretroviral therapy in hiv- infected indian children
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4297378/
https://www.ncbi.nlm.nih.gov/pubmed/25539905
http://dx.doi.org/10.1186/s12879-014-0701-2
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