Abstract
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.
| Original language | English |
|---|---|
| Article number | 1471 |
| Pages (from-to) | 140 |
| Number of pages | 1 |
| Journal | BMC Infectious Diseases |
| Volume | 9 |
| DOIs | |
| Publication status | Published - Aug 26 2009 |
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ASJC Scopus subject areas
- Infectious Diseases
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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.
In: BMC Infectious Diseases, Vol. 9, 1471, 26.08.2009, p. 140.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Five-year follow-up of children with perinatal HIV-1 infection receiving early highly active antiretroviral therapy
AU - Chiappini, Elena
AU - Galli, Luisa
AU - Tovo, Pier Angelo
AU - Gabiano, Clara
AU - Lisi, Catiuscia
AU - Bernardi, Stefania
AU - Viganò, Alessandra
AU - Guarino, Alfredo
AU - Giaquinto, Carlo
AU - Esposito, Susanna
AU - Badolato, Raffaele
AU - Di Bari, Cesare
AU - Rosso, Raffaella
AU - Genovese, Orazio
AU - Masi, Massimo
AU - Mazza, Antonio
AU - De Martino, Maurizio
PY - 2009/8/26
Y1 - 2009/8/26
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=70449393899&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70449393899&partnerID=8YFLogxK
U2 - 10.1186/1471-2334-9-140
DO - 10.1186/1471-2334-9-140
M3 - Article
C2 - 19709432
AN - SCOPUS:70449393899
VL - 9
SP - 140
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
SN - 1471-2334
M1 - 1471
ER -