Trends in antiretroviral therapy use and survival rates for a large cohort of HIV-infected children and adolescents in the United States, 1989-2001
Trends in antiretroviral therapy use and survival rates for a large cohort of HIV-infected children and adolescents in the United States, 1989-2001
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DOI：
10.1097/01.qai.0000134744.72079.cc
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发表时间：
2005-04-01
影响因子：
3.6
通讯作者：
Fowler, MG
中科院分区：
文献类型：
--
作者：
McConnell, MS;Byers, RH;Fowler, MG
背景资料：在美国，艾滋病毒感染的儿童和青少年正在老化，并使用抗逆转录病毒（ARV）治疗的延长periods.Objective：评估趋势ARV的使用和长期生存在一个观察队列的HIV感染的儿童和青少年在Uniteds.Methods：儿科谱的HIV疾病研究（PSD）是一个前瞻性的图表审查超过2000艾滋病毒感染的儿童和青少年。从入组到最后一次随访，患者均被纳入分析中。结果：1997年至2001年间，三重ARV治疗（持续6个月或以上）的使用率从27%增加到66%（p < 0.0001，chi（2）代表趋势）。在1997年至2001年期间，接受3种或3种以上序贯三联治疗方案的患者比例也从4%增加到17%（p < 0.0001，趋势卡方2），然而，三联治疗方案的持续时间从第一种方案减少到第三种方案，从13个月减少到7个月。1997年至2001年出生队列的生存率明显好于1989年至1993年和1994年至1996年队列（P < 0.0001）。结论：PSD队列的生存率与三联抗逆转录病毒治疗的使用相关。随着抗逆转录病毒治疗方案的不断变化，需要确定抗逆转录病毒治疗的有效改进和生存率提高的可持续性。
Background: In the United States, HIV-infected children and adolescents are aging and using antiretroviral (ARV) therapy for extended periods of time.Objective: To assess trends in ARV use and long-term survival in an observational cohort of HIV-infected children and adolescents in the United States.Methods: The Pediatric Spectrum of HIV Disease Study (PSD) is a prospective chart review of more than 2000 HIV-infected children and adolescents. Patients were included in the analysis from enrollment until last follow-up.Results: Triple-ARV therapy use (for 6 months or more) increased from 27% to 66% during 1997 to 2001 (p < 0.0001, chi(2) for trend). The proportion of patients receiving 3 or more sequential triple-therapy regimens also increased from 4% to 17% during 1997 to 2001 (p < 0.0001, chi(2) for trend), however, and the durability of triple-therapy regimens decreased from 13 to 7 months from the first to third regimen. Survival rates for the 1997 to 2001 birth cohorts were significantly better than for the 1989 to 1993 and 1994 to 1996 cohorts (P < 0.0001).Conclusions: Survival rates in the PSD cohort have increased in association with triple-ARV therapy use. With continued changes in ARV regimens, effective modifications in ARV therapy and the sustainability of gains in survival need to be determined.