Antiretroviral use in Italian children with perinatal HIV infection over a 14-year period

Elena Chiappini, Luisa Galli, Pier Angelo Tovo, Clara Gabiano, Catiuscia Lisi, Vania Giacomet, Stefania Bernardi, Susanna Esposito, Raffaella Rosso, Carlo Giaquinto, Raffaele Badolato, Alfredo Guarino, Anna MacCabruni, Massimo Masi, Monica Cellini, Filippo Salvini, Cesare Di Bari, Maurizio Dedoni, Icilio Dodi, Maurizio De Martino

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Abstract

Background: Information on the use of new antiretroviral drugs in children in the real setting of clinical fields is largely unknown. Methods: Data from 2554 combined antiretroviral therapy (cART) regimens administered to 911 children enrolled in the Italian Register for HIV infection in children, between 1996 and 2009, were analysed. Factors potentially associated with undetectable viral load and immunological response to cART were explored by Cox regression analysis. Results: Proportion of protease inhibitor (PI)-based regimens significantly decreased from 88.0% to 51.2% and 54.9%, while proportion on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens increased from 4.5% to 38.8% and 40.2% in 1996-1999, 2000-2004 and 2005-2009, respectively (p <0.0001). Significant change in the use of each antiretroviral drug occurred over the time periods (p <0.0001). Factors independently associated with virological and immunological success were as follows: later calendar periods, younger age at regimen (only for virological success) and higher CD4 + T-lymphocyte percentage at baseline. Use of unboosted PI was associated with lower adjusted hazard ratio (aHR) of virological or immunological success with respect to NNRTI- and boosted PI-based regimens, with no difference among these two latter types. Conclusion: Use of new generation antiretroviral drugs in Italian HIV-infected children is increasing. No different viro-immunological outcomes between NNRTI- and boosted PI-based cART were observed.

Original languageEnglish
JournalActa Paediatrica, International Journal of Paediatrics
Volume101
Issue number7
DOIs
Publication statusPublished - Jul 2012

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Keywords

  • Antiretroviral drugs
  • Cohort study
  • Perinatal HIV infection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Chiappini, E., Galli, L., Tovo, P. A., Gabiano, C., Lisi, C., Giacomet, V., Bernardi, S., Esposito, S., Rosso, R., Giaquinto, C., Badolato, R., Guarino, A., MacCabruni, A., Masi, M., Cellini, M., Salvini, F., Di Bari, C., Dedoni, M., Dodi, I., & De Martino, M. (2012). Antiretroviral use in Italian children with perinatal HIV infection over a 14-year period. Acta Paediatrica, International Journal of Paediatrics, 101(7). https://doi.org/10.1111/j.1651-2227.2012.02675.x