Highly active antiretroviral therapies among HIV-1 infected children in Abidjan, Cote d'Ivoire
Highly active antiretroviral therapies among HIV-1 infected children in Abidjan, Cote d'Ivoire
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DOI：
10.1097/00002030-200409240-00006
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发表时间：
2004-09-24
期刊：
影响因子：
3.8
通讯作者：
Msellati, P
中科院分区：
文献类型：
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作者：
Fassinou, P;Elenga, N;Msellati, P
目的：描述高效抗逆转录病毒疗法（HAART）对HIV-1感染的非洲儿童的影响。研究设计：2000年10月至2002年9月期间159名HIV感染儿童的观察性ANRS 1244队列; 78名儿童（49%）接受HAART治疗，平均随访时间为21个月。在开始HAART治疗前和治疗期间每6个月测量年龄别体重Z评分（WAZ）、年龄别身高Z评分（HAZ）、CD 4淋巴细胞计数和HIV-1 RNA病毒载量。结果：HAART治疗前和治疗后620天的平均WAZ分别为-2.02和-1.39，（P < 0.01）;平均HAZ为-2.03和-1.83（P = 0.51）; 0.07和0.025/儿童月急性腹泻发病率分别为0.12和0.048/儿童月（P <0.001）（发病率变化仅在< 6.5岁的儿童中具有统计学意义）。总体而言，在HAART治疗下，CD 4细胞< 5%的儿童24个月的生存率为72.8%，而CD 4细胞大于或等于5%的儿童为97.8%（P < 0.01）。在HAART开始时，中位病毒载量和CD 4细胞百分比分别为5.41 log（10）拷贝/ml和7.7%。HAART治疗756天后，平均50%的患者病毒载量检测不到，10%的患者病毒载量为2.4-3.0 log（10）拷贝/ml。结论：在资源有限的情况下，HAART治疗非洲儿童是可行的。这种治疗似乎与发达国家一样有效。(C)2004年利平科特威廉姆斯威尔金斯。
Objective: To describe the effect of highly active antiretroviral therapy (HAART) in HIV-1-infected African children.Study design: Observational ANRS 1244 cohort of 159 children with HIV between October 2000 and September 2002; 78 children (49%) receiving HAART were followed for a mean duration of 21 months.Methods: Weight-for-age Z-scores (WAZ), height-for-age Z-scores (HAZ), CD4 lymphocyte count and HIV-1 RNA viral load were measured before initiating HAART and every 6 months during treatment. Probability of survival and incidences of pneumonia and acute diarrhoea were calculated.Results: Values before and after 620 days of HAART, respectively, were -2.02 and -1.39 for mean WAZ, (P < 0.01); -2.03 and -1.83 for mean HAZ (P = 0.51); 0.07 and 0.025/child-month (P = 0.002) for incidence of pneumonia; and 0.12 and 0.048/ child-month for incidence of acute diarrhoea (P < 0.001) (incidence changes statistically significant only in children < 6.5 years). Overall, the probability of survival under HAART was 72.8% at 24 months for children with < 5% CD4 cells versus 97.8% in children with greater than or equal to 5% (P < 0.01). At HAART initiation, median viral load and CD4 cell percentage were 5.41 log(10) copies/ml and 7.7%, respectively. After 756 days of HAART, on average, 50% of patients had undetectable viral load and 10% had 2.4-3.0 log(10) copies/ml. The median CD4 percentage was 22.5%.Conclusion: In resource-limited setting, it is possible to use HAART to treat African children. This treatment appears as effective as in developed countries. (C) 2004 Lippincott Williams Wilkins.