Abstract
BACKGROUND: The introduction of HAART has decreased mortality and progression to AIDS in perinatally HIV-1-infected children, but information on modification of the rate of specific clinical events is limited. METHOD: An observational population study on changes in HIV-1-related morbidity was conducted on 1402 perinatally HIV-1-infected children enrolled in the Italian Register for HIV Infection in Children and prospectively followed in the pre-HAART (1985-1995) and post-HAART periods (1996-2000, and 2001-2005). Of this group, 773 children (55.1%) were followed from birth. Median observation time was 8.58 years (interquartile range, 3.71-13.72). RESULTS: Overall, 666 (47.5%) children developed AIDS and 420 (29.9%) died. Improved survival over time was evidenced at Kaplan-Meier analysis (P <0.0001). Poisson regression analysis indicated that Centers for Disease Control and Prevention class B and C clinical event rates and most of the HIV-1-related organ complication rates significantly decreased starting from 1996-2000. Significant reductions in rates of cancer and opportunistic infections were evidenced after 2000. Nevertheless, opportunistic infections still occurred at high rates (6.09/100 person-years) in 2001-2005, with high rate of bacterial infections (3.55/100 person-years), particularly pneumonia (1.66/100 person-years), in this period. CD4 cell percentage was > 15% in 58.5% children with pneumonia. CONCLUSIONS: Progressive reductions of both mortality and rates of class B and C clinical events, including organ complications, were evidenced in the HAART era. Nevertheless, severe bacterial infections, particularly pneumonia, still occurred at considerable high rates, even in the absence of a severe CD4 cell depletion.
| Original language | English |
|---|---|
| Pages (from-to) | 1607-1615 |
| Number of pages | 9 |
| Journal | AIDS (London, England) |
| Volume | 21 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Jul 2007 |
Fingerprint
Keywords
- Children
- Combined antiretroviral therapy
- HIV-infection
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
Cite this
Changing patterns of clinical events in perinatally HIV-1-infected children during the era of HAART. / Chiappini, Elena; Galli, Luisa; Tovo, Pier Angelo; Gabiano, Clara; Lisi, Catiuscia; Gattinara, Guido Castelli; Esposito, Susanna; Viganò, Alessandra; Giaquinto, Carlo; Rosso, Raffaella; Guarino, Alfredo; De Martino, Maurizio.
In: AIDS (London, England), Vol. 21, No. 12, 07.2007, p. 1607-1615.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Changing patterns of clinical events in perinatally HIV-1-infected children during the era of HAART
AU - Chiappini, Elena
AU - Galli, Luisa
AU - Tovo, Pier Angelo
AU - Gabiano, Clara
AU - Lisi, Catiuscia
AU - Gattinara, Guido Castelli
AU - Esposito, Susanna
AU - Viganò, Alessandra
AU - Giaquinto, Carlo
AU - Rosso, Raffaella
AU - Guarino, Alfredo
AU - De Martino, Maurizio
PY - 2007/7
Y1 - 2007/7
N2 - BACKGROUND: The introduction of HAART has decreased mortality and progression to AIDS in perinatally HIV-1-infected children, but information on modification of the rate of specific clinical events is limited. METHOD: An observational population study on changes in HIV-1-related morbidity was conducted on 1402 perinatally HIV-1-infected children enrolled in the Italian Register for HIV Infection in Children and prospectively followed in the pre-HAART (1985-1995) and post-HAART periods (1996-2000, and 2001-2005). Of this group, 773 children (55.1%) were followed from birth. Median observation time was 8.58 years (interquartile range, 3.71-13.72). RESULTS: Overall, 666 (47.5%) children developed AIDS and 420 (29.9%) died. Improved survival over time was evidenced at Kaplan-Meier analysis (P <0.0001). Poisson regression analysis indicated that Centers for Disease Control and Prevention class B and C clinical event rates and most of the HIV-1-related organ complication rates significantly decreased starting from 1996-2000. Significant reductions in rates of cancer and opportunistic infections were evidenced after 2000. Nevertheless, opportunistic infections still occurred at high rates (6.09/100 person-years) in 2001-2005, with high rate of bacterial infections (3.55/100 person-years), particularly pneumonia (1.66/100 person-years), in this period. CD4 cell percentage was > 15% in 58.5% children with pneumonia. CONCLUSIONS: Progressive reductions of both mortality and rates of class B and C clinical events, including organ complications, were evidenced in the HAART era. Nevertheless, severe bacterial infections, particularly pneumonia, still occurred at considerable high rates, even in the absence of a severe CD4 cell depletion.
AB - BACKGROUND: The introduction of HAART has decreased mortality and progression to AIDS in perinatally HIV-1-infected children, but information on modification of the rate of specific clinical events is limited. METHOD: An observational population study on changes in HIV-1-related morbidity was conducted on 1402 perinatally HIV-1-infected children enrolled in the Italian Register for HIV Infection in Children and prospectively followed in the pre-HAART (1985-1995) and post-HAART periods (1996-2000, and 2001-2005). Of this group, 773 children (55.1%) were followed from birth. Median observation time was 8.58 years (interquartile range, 3.71-13.72). RESULTS: Overall, 666 (47.5%) children developed AIDS and 420 (29.9%) died. Improved survival over time was evidenced at Kaplan-Meier analysis (P <0.0001). Poisson regression analysis indicated that Centers for Disease Control and Prevention class B and C clinical event rates and most of the HIV-1-related organ complication rates significantly decreased starting from 1996-2000. Significant reductions in rates of cancer and opportunistic infections were evidenced after 2000. Nevertheless, opportunistic infections still occurred at high rates (6.09/100 person-years) in 2001-2005, with high rate of bacterial infections (3.55/100 person-years), particularly pneumonia (1.66/100 person-years), in this period. CD4 cell percentage was > 15% in 58.5% children with pneumonia. CONCLUSIONS: Progressive reductions of both mortality and rates of class B and C clinical events, including organ complications, were evidenced in the HAART era. Nevertheless, severe bacterial infections, particularly pneumonia, still occurred at considerable high rates, even in the absence of a severe CD4 cell depletion.
KW - Children
KW - Combined antiretroviral therapy
KW - HIV-infection
UR - http://www.scopus.com/inward/record.url?scp=34447578624&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34447578624&partnerID=8YFLogxK
U2 - 10.1097/QAD.0b013e32823ecf5b
DO - 10.1097/QAD.0b013e32823ecf5b
M3 - Article
C2 - 17630556
AN - SCOPUS:34447578624
VL - 21
SP - 1607
EP - 1615
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 12
ER -