In:
Antiviral Therapy, SAGE Publications, Vol. 18, No. 4 ( 2013-05), p. 1-8
Abstract:
The World Health Organization (WHO) recommends boosted protease inhibitor (bPI)-based HAART after failing non-nucleoside reverse transcriptase inhibitor (NNRTI) treatment. We examined outcomes of this regimen in Asian HIV-infected children. Methods Children from five Asian countries in the TREAT Asia Pediatric HIV Observational Database (TApHOD) with ≥24 weeks of NNRTI-based HAART followed by ≥24 weeks of bPI-based HAART were eligible. Primary outcomes were the proportions with virological suppression (HIV RNA 〈 400 copies/ml) and immune recovery (CD4 + T-cell percentage [CD4%]≥25% if age 〈 5 years and CD4 + T-cell count ≥500 cells/mm 3 if age ≥5 years) at 48 and 96 weeks. Results Of 3,422 children, 153 were eligible; 52% were female. At switch, median age was 10 years, 26% were in WHO stage 4. Median weight-for-age z-score (WAZ) was -1.9 ( n=121), CD4% was 12.5% ( n=106), CD4 + T-cell count was 237 cells/mm 3 ( n=112), and HIV RNA was 4.6 log 10 copies/ml ( n=61). The most common bPI was lopinavir/ritonavir (83%). At 48 weeks, 61% (79/129) had immune recovery, 60% (26/43) had undetectable HIV RNA and 73% (58/79) had fasting triglycerides ≥130 mg/dl. By 96 weeks, 70% (57/82) achieved immune recovery, 65% (17/26) had virological suppression, and hypertriglyceridaemia occurred in 66% (33/50). Predictors for virological suppression at week 48 were longer duration of NNRTI-based HAART ( P=0.006), younger age ( P=0.007), higher WAZ ( P=0.020) and HIV RNA at switch 〈 10,000 copies/ml ( P=0.049). Conclusions In this regional cohort of Asian children on bPI-based second-line HAART, 60% of children tested had immune recovery by 1 year, and two-thirds had hyper-lipidaemia, highlighting difficulties in optimizing second-line HAART with limited drug options.
Type of Medium:
Online Resource
ISSN:
1359-6535
,
2040-2058
Language:
English
Publisher:
SAGE Publications
Publication Date:
2013
detail.hit.zdb_id:
2118396-X
detail.hit.zdb_id:
1339842-8
SSG:
15,3
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