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2526. Side Effects of Antiretroviral Therapy in Children with HIV in a Referral Center in Mexico

BACKGROUND: Human Inmunodeficiency Virus infection (HIV) is still a challenge in many parts of the world, mainly in children. In Mexico the infection has been decreasing, however we still have cases, in 2018 we had 40 perinatal new cases reported. The antiretroviral therapy has shown to be effective...

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Autores principales: Diaz, Luis Xochihua, Ortega, Javier Ordoñez, Lopez, Karen Alejandra Linares, Garcia, Itzel Villanueva, Gutierrez, Jose Luis Copado
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810423/
http://dx.doi.org/10.1093/ofid/ofz360.2204
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author Diaz, Luis Xochihua
Ortega, Javier Ordoñez
Lopez, Karen Alejandra Linares
Garcia, Itzel Villanueva
Gutierrez, Jose Luis Copado
author_facet Diaz, Luis Xochihua
Ortega, Javier Ordoñez
Lopez, Karen Alejandra Linares
Garcia, Itzel Villanueva
Gutierrez, Jose Luis Copado
author_sort Diaz, Luis Xochihua
collection PubMed
description BACKGROUND: Human Inmunodeficiency Virus infection (HIV) is still a challenge in many parts of the world, mainly in children. In Mexico the infection has been decreasing, however we still have cases, in 2018 we had 40 perinatal new cases reported. The antiretroviral therapy has shown to be effective to control the disease but it is not free of adverse effects, the children with vertical transmission are exposed to many years of the antiretroviral therapy. METHODS: Retrospective, observational descriptive study at Instituto Nacional de Pediatría during 2004–2019. We included every children under 18 years old who received treatment for HIV and had a complete medical record. RESULTS: We found 61 patients under 18 years that fulfill the data for the analysis. 37 (60%) were male, the mean age at diagnosis of HIV infection was 47 months, the antiretroviral therapy that received 57 patients (93.4%) of the study was zidovudine, lamivudine and lopinavir/ritonavir, only 4 received another therapy: 3 of them received abacavir, lamivudine, and lopinavir/ritonavir and the missing one received abacavir, lamivudine and raltegravir. 43% of the children of our study showed adverse effects after the antiretroviral therapy, the mean time of adverse effects presentation was 37 months after the beginning of the treatment. The most common effect was hypertriglyceridemia with 13 cases, in second place we found hypercholesterolemia in 7 cases, and both in 5 cases, other frequent effects were hepatotoxicity in 5 cases, diarrhea in 4 cases, anemia in 3 cases, vomit in 3 cases, abdominal pain and night terrors in 2 cases each one. It was necessary the change of the therapy because of adverse effects in 6 cases (9.8%). CONCLUSION: Antiretroviral therapy is effective although it has many side effects. We observe that adverse effects are frequent, almost the half, in pediatric population, it depends on the antiretroviral selection, for children we had only a few options because of the little doses they need or the inability to swallow tablets. It′s important to monitor and control all the adverse effects because they increase morbidity and mortality, especially dyslipidemia, that has been associated with cardiovascular risk and it was the most common effect found in our study. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68104232019-10-28 2526. Side Effects of Antiretroviral Therapy in Children with HIV in a Referral Center in Mexico Diaz, Luis Xochihua Ortega, Javier Ordoñez Lopez, Karen Alejandra Linares Garcia, Itzel Villanueva Gutierrez, Jose Luis Copado Open Forum Infect Dis Abstracts BACKGROUND: Human Inmunodeficiency Virus infection (HIV) is still a challenge in many parts of the world, mainly in children. In Mexico the infection has been decreasing, however we still have cases, in 2018 we had 40 perinatal new cases reported. The antiretroviral therapy has shown to be effective to control the disease but it is not free of adverse effects, the children with vertical transmission are exposed to many years of the antiretroviral therapy. METHODS: Retrospective, observational descriptive study at Instituto Nacional de Pediatría during 2004–2019. We included every children under 18 years old who received treatment for HIV and had a complete medical record. RESULTS: We found 61 patients under 18 years that fulfill the data for the analysis. 37 (60%) were male, the mean age at diagnosis of HIV infection was 47 months, the antiretroviral therapy that received 57 patients (93.4%) of the study was zidovudine, lamivudine and lopinavir/ritonavir, only 4 received another therapy: 3 of them received abacavir, lamivudine, and lopinavir/ritonavir and the missing one received abacavir, lamivudine and raltegravir. 43% of the children of our study showed adverse effects after the antiretroviral therapy, the mean time of adverse effects presentation was 37 months after the beginning of the treatment. The most common effect was hypertriglyceridemia with 13 cases, in second place we found hypercholesterolemia in 7 cases, and both in 5 cases, other frequent effects were hepatotoxicity in 5 cases, diarrhea in 4 cases, anemia in 3 cases, vomit in 3 cases, abdominal pain and night terrors in 2 cases each one. It was necessary the change of the therapy because of adverse effects in 6 cases (9.8%). CONCLUSION: Antiretroviral therapy is effective although it has many side effects. We observe that adverse effects are frequent, almost the half, in pediatric population, it depends on the antiretroviral selection, for children we had only a few options because of the little doses they need or the inability to swallow tablets. It′s important to monitor and control all the adverse effects because they increase morbidity and mortality, especially dyslipidemia, that has been associated with cardiovascular risk and it was the most common effect found in our study. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6810423/ http://dx.doi.org/10.1093/ofid/ofz360.2204 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Diaz, Luis Xochihua
Ortega, Javier Ordoñez
Lopez, Karen Alejandra Linares
Garcia, Itzel Villanueva
Gutierrez, Jose Luis Copado
2526. Side Effects of Antiretroviral Therapy in Children with HIV in a Referral Center in Mexico
title 2526. Side Effects of Antiretroviral Therapy in Children with HIV in a Referral Center in Mexico
title_full 2526. Side Effects of Antiretroviral Therapy in Children with HIV in a Referral Center in Mexico
title_fullStr 2526. Side Effects of Antiretroviral Therapy in Children with HIV in a Referral Center in Mexico
title_full_unstemmed 2526. Side Effects of Antiretroviral Therapy in Children with HIV in a Referral Center in Mexico
title_short 2526. Side Effects of Antiretroviral Therapy in Children with HIV in a Referral Center in Mexico
title_sort 2526. side effects of antiretroviral therapy in children with hiv in a referral center in mexico
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810423/
http://dx.doi.org/10.1093/ofid/ofz360.2204
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