Management of vertically HIV-infected children in Europe

C. Thorne, L. Gray, Marie Louise Newell, C. Giaquinto, E. Ruga, A. De Rossi, I. Grosch-Würner, J. Mok, F. Johnstone, I. De José, I. Bates, F. Hawkins, C. Ladrón De Guevara, J. M. Peña, J. Gonzalez Garcia, J. R. Arribas Lopez, M. C. Garcia-Rodriguez, F. Asensi-Botet, M. C. Otero, D. Pérez-TamaritS. Ridaura, P. Gregori, R. De La Torre, H. Scherpbier, M. Kreyenbroek, K. Boer, A. B. Bohlin, E. Belfrage, L. Navér, J. Levy, P. Barlow, M. Hainaut, A. Peltier, S. Wibaut, A. Ferrazin, D. Bassetti, A. De Maria, C. Gotta, A. Mûr, A. Payà, M. Viñolas, M. A. López-Vilchez, [No Value] Rovira, R. Carreras

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Aim: To describe policies for the therapeutic management of vertically HIV-infected children, and to compare these with practice, using children enrolled in a cohort study in the same setting. Methods: A postal questionnaire survey of clinicians in the paediatric centres of the European Collaborative Study (ECS) was used. Prospective data collected within the ECS on the treatment and clinical status of infected children seen in these centres in 1999-2001 were analysed and compared with the year 2000 policies reported. Results: C ThorneIn 3 of the 10 centres, the policy was routinely to. administer antiretroviral therapy (ART) to infants upon confirmation of infection, and in 7 centres initiation of therapy was delayed until specific clinical, virological and immunological criteria were reached. Evidence of disease progression was a reason for treatment modification in all centres; other considerations included adherence problems and side effects. However, practice did not always match policy. For the 84 children with at least 5 y of follow-up (73 treated and 11 untreated), overall, 69% of the 420 person-years lived were spent without treatment, and 72% without any HIV-related symptoms. Untreated children were without symptoms for 94% of these 5 y, whereas treated children spent nearly a third of their time with mild or moderately severe symptoms. Conclusions: Therapeutic management of paediatric HIV disease requires a balance between preventing disease progression and minimizing adherence problems and side effects. This is important, as most infected children are without symptoms most of the time. Recent European consensus guidelines for the treatment of infected children will facilitate management.

Original languageEnglish
Pages (from-to)246-250
Number of pages5
JournalActa Paediatrica, International Journal of Paediatrics
Volume92
Issue number2
Publication statusPublished - 2003

Fingerprint

HIV
Therapeutics
Disease Progression
Pediatrics
Cohort Studies
Guidelines
Infection

Keywords

  • Antiretroviral therapy
  • Europe
  • HIV infection
  • Policy
  • Practice

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Thorne, C., Gray, L., Newell, M. L., Giaquinto, C., Ruga, E., De Rossi, A., ... Carreras, R. (2003). Management of vertically HIV-infected children in Europe. Acta Paediatrica, International Journal of Paediatrics, 92(2), 246-250.

Management of vertically HIV-infected children in Europe. / Thorne, C.; Gray, L.; Newell, Marie Louise; Giaquinto, C.; Ruga, E.; De Rossi, A.; Grosch-Würner, I.; Mok, J.; Johnstone, F.; De José, I.; Bates, I.; Hawkins, F.; Ladrón De Guevara, C.; Peña, J. M.; Gonzalez Garcia, J.; Arribas Lopez, J. R.; Garcia-Rodriguez, M. C.; Asensi-Botet, F.; Otero, M. C.; Pérez-Tamarit, D.; Ridaura, S.; Gregori, P.; De La Torre, R.; Scherpbier, H.; Kreyenbroek, M.; Boer, K.; Bohlin, A. B.; Belfrage, E.; Navér, L.; Levy, J.; Barlow, P.; Hainaut, M.; Peltier, A.; Wibaut, S.; Ferrazin, A.; Bassetti, D.; De Maria, A.; Gotta, C.; Mûr, A.; Payà, A.; Viñolas, M.; López-Vilchez, M. A.; Rovira, [No Value]; Carreras, R.

In: Acta Paediatrica, International Journal of Paediatrics, Vol. 92, No. 2, 2003, p. 246-250.

Research output: Contribution to journalArticle

Thorne, C, Gray, L, Newell, ML, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Würner, I, Mok, J, Johnstone, F, De José, I, Bates, I, Hawkins, F, Ladrón De Guevara, C, Peña, JM, Gonzalez Garcia, J, Arribas Lopez, JR, Garcia-Rodriguez, MC, Asensi-Botet, F, Otero, MC, Pérez-Tamarit, D, Ridaura, S, Gregori, P, De La Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Belfrage, E, Navér, L, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Ferrazin, A, Bassetti, D, De Maria, A, Gotta, C, Mûr, A, Payà, A, Viñolas, M, López-Vilchez, MA, Rovira, NV & Carreras, R 2003, 'Management of vertically HIV-infected children in Europe', Acta Paediatrica, International Journal of Paediatrics, vol. 92, no. 2, pp. 246-250.
Thorne, C. ; Gray, L. ; Newell, Marie Louise ; Giaquinto, C. ; Ruga, E. ; De Rossi, A. ; Grosch-Würner, I. ; Mok, J. ; Johnstone, F. ; De José, I. ; Bates, I. ; Hawkins, F. ; Ladrón De Guevara, C. ; Peña, J. M. ; Gonzalez Garcia, J. ; Arribas Lopez, J. R. ; Garcia-Rodriguez, M. C. ; Asensi-Botet, F. ; Otero, M. C. ; Pérez-Tamarit, D. ; Ridaura, S. ; Gregori, P. ; De La Torre, R. ; Scherpbier, H. ; Kreyenbroek, M. ; Boer, K. ; Bohlin, A. B. ; Belfrage, E. ; Navér, L. ; Levy, J. ; Barlow, P. ; Hainaut, M. ; Peltier, A. ; Wibaut, S. ; Ferrazin, A. ; Bassetti, D. ; De Maria, A. ; Gotta, C. ; Mûr, A. ; Payà, A. ; Viñolas, M. ; López-Vilchez, M. A. ; Rovira, [No Value] ; Carreras, R. / Management of vertically HIV-infected children in Europe. In: Acta Paediatrica, International Journal of Paediatrics. 2003 ; Vol. 92, No. 2. pp. 246-250.
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abstract = "Aim: To describe policies for the therapeutic management of vertically HIV-infected children, and to compare these with practice, using children enrolled in a cohort study in the same setting. Methods: A postal questionnaire survey of clinicians in the paediatric centres of the European Collaborative Study (ECS) was used. Prospective data collected within the ECS on the treatment and clinical status of infected children seen in these centres in 1999-2001 were analysed and compared with the year 2000 policies reported. Results: C ThorneIn 3 of the 10 centres, the policy was routinely to. administer antiretroviral therapy (ART) to infants upon confirmation of infection, and in 7 centres initiation of therapy was delayed until specific clinical, virological and immunological criteria were reached. Evidence of disease progression was a reason for treatment modification in all centres; other considerations included adherence problems and side effects. However, practice did not always match policy. For the 84 children with at least 5 y of follow-up (73 treated and 11 untreated), overall, 69{\%} of the 420 person-years lived were spent without treatment, and 72{\%} without any HIV-related symptoms. Untreated children were without symptoms for 94{\%} of these 5 y, whereas treated children spent nearly a third of their time with mild or moderately severe symptoms. Conclusions: Therapeutic management of paediatric HIV disease requires a balance between preventing disease progression and minimizing adherence problems and side effects. This is important, as most infected children are without symptoms most of the time. Recent European consensus guidelines for the treatment of infected children will facilitate management.",
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AU - Thorne, C.

AU - Gray, L.

AU - Newell, Marie Louise

AU - Giaquinto, C.

AU - Ruga, E.

AU - De Rossi, A.

AU - Grosch-Würner, I.

AU - Mok, J.

AU - Johnstone, F.

AU - De José, I.

AU - Bates, I.

AU - Hawkins, F.

AU - Ladrón De Guevara, C.

AU - Peña, J. M.

AU - Gonzalez Garcia, J.

AU - Arribas Lopez, J. R.

AU - Garcia-Rodriguez, M. C.

AU - Asensi-Botet, F.

AU - Otero, M. C.

AU - Pérez-Tamarit, D.

AU - Ridaura, S.

AU - Gregori, P.

AU - De La Torre, R.

AU - Scherpbier, H.

AU - Kreyenbroek, M.

AU - Boer, K.

AU - Bohlin, A. B.

AU - Belfrage, E.

AU - Navér, L.

AU - Levy, J.

AU - Barlow, P.

AU - Hainaut, M.

AU - Peltier, A.

AU - Wibaut, S.

AU - Ferrazin, A.

AU - Bassetti, D.

AU - De Maria, A.

AU - Gotta, C.

AU - Mûr, A.

AU - Payà, A.

AU - Viñolas, M.

AU - López-Vilchez, M. A.

AU - Rovira, [No Value]

AU - Carreras, R.

PY - 2003

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