TY - JOUR
T1 - Real-World Analysis of Survival and Clinical Events in a Cohort of Italian Perinatally HIV-1 Infected Children From 2001 to 2018
AU - for the Italian Register for HIV Infection in Children
AU - Chiappini, Elena
AU - Larotonda, Francesca
AU - Lisi, Catiuscia
AU - Giacomet, Vania
AU - Erba, Paola
AU - Bernardi, Stefania
AU - Zangari, Paola
AU - Di Biagio, Antonio
AU - Taramasso, Lucia
AU - Giaquinto, Carlo
AU - Rampon, Osvalda
AU - Gabiano, Clara
AU - Garazzino, Silvia
AU - Tagliabue, Claudia
AU - Esposito, Susanna
AU - Bruzzese, Eugenia
AU - Badolato, Raffaele
AU - Zanaboni, Domenico
AU - Cellini, Monica
AU - Dedoni, Maurizio
AU - Mazza, Antonio
AU - Pession, Andrea
AU - Giannini, Anna Maria
AU - Salvini, Filippo
AU - Dodi, Icilio
AU - Carloni, Ines
AU - Cazzato, Salvatore
AU - Tovo, Pier Angelo
AU - de Martino, Maurizio
AU - Galli, Luisa
N1 - Funding Information:
Funding. This study was funded by the University of Florence.
Publisher Copyright:
© Copyright © 2021 Chiappini, Larotonda, Lisi, Giacomet, Erba, Bernardi, Zangari, Di Biagio, Taramasso, Giaquinto, Rampon, Gabiano, Garazzino, Tagliabue, Esposito, Bruzzese, Badolato, Zanaboni, Cellini, Dedoni, Mazza, Pession, Giannini, Salvini, Dodi, Carloni, Cazzato, Tovo, de Martino and Galli.
PY - 2021/7/16
Y1 - 2021/7/16
N2 - Background: Combined antiretroviral therapy (cART) has been associated with a steep decrease in mortality and morbidity in HIV-1 infected children. New antiretroviral molecules and drug classes have been developed and the management of HIV-infected children has improved, but recent data on survival are limited. Methods: An observational retrospective study investigating changes in mortality and morbidity was conducted on 1,091 perinatally HIV-1 infected children enrolled in the Italian Register for HIV Infection in Children and followed-up from 2001 to 2018. Results: Three hundred and fifty-four (32%) AIDS events and 26 (2%) deaths occurred overtime. Mortality rates decreased from 0.4/100 person-years in 2001–2006 to 0.27/100 person-years in 2007–2012 and 0.07/100 person-years in 2013–2018. Notably, 92% of the dead children were born in Italy, but only 50% were followed-up since birth or within three months of age. Seventy three percent of children had started cART at age ≥6 months; 23% were treated for <30 days before death. B and C clinical events progressively decreased (P < 0.0001). Opportunistic infections significantly decreased over time, but still were the most common events in all the periods (6.76/100 person-years in 2013–2018). In the last period, severe bacterial infections were the most common ones. Cancer rates were 0.07/100; 0.17/100; 0.07/100 person-years in the three periods, respectively. Conclusions: Progressive reductions both in mortality and in rates of class B and C clinical events and OIs have been observed during the cART era. However, deaths were still registered; more than half of dead children were enrolled after birth and had belatedly started cART.
AB - Background: Combined antiretroviral therapy (cART) has been associated with a steep decrease in mortality and morbidity in HIV-1 infected children. New antiretroviral molecules and drug classes have been developed and the management of HIV-infected children has improved, but recent data on survival are limited. Methods: An observational retrospective study investigating changes in mortality and morbidity was conducted on 1,091 perinatally HIV-1 infected children enrolled in the Italian Register for HIV Infection in Children and followed-up from 2001 to 2018. Results: Three hundred and fifty-four (32%) AIDS events and 26 (2%) deaths occurred overtime. Mortality rates decreased from 0.4/100 person-years in 2001–2006 to 0.27/100 person-years in 2007–2012 and 0.07/100 person-years in 2013–2018. Notably, 92% of the dead children were born in Italy, but only 50% were followed-up since birth or within three months of age. Seventy three percent of children had started cART at age ≥6 months; 23% were treated for <30 days before death. B and C clinical events progressively decreased (P < 0.0001). Opportunistic infections significantly decreased over time, but still were the most common events in all the periods (6.76/100 person-years in 2013–2018). In the last period, severe bacterial infections were the most common ones. Cancer rates were 0.07/100; 0.17/100; 0.07/100 person-years in the three periods, respectively. Conclusions: Progressive reductions both in mortality and in rates of class B and C clinical events and OIs have been observed during the cART era. However, deaths were still registered; more than half of dead children were enrolled after birth and had belatedly started cART.
KW - aids
KW - antiretroviral therapy (ART)
KW - children
KW - epidemiology
KW - HIV
KW - perinatal infection
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85111615868&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85111615868&partnerID=8YFLogxK
U2 - 10.3389/fped.2021.665764
DO - 10.3389/fped.2021.665764
M3 - Article
AN - SCOPUS:85111615868
VL - 9
JO - Frontiers in Pediatrics
JF - Frontiers in Pediatrics
SN - 2296-2360
M1 - 665764
ER -