Long-term survival and immuno-virological response of African HIV-1-infected children to highly active antiretroviral therapy regimens
Long-term survival and immuno-virological response of African HIV-1-infected children to highly active antiretroviral therapy regimens
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DOI：
10.1097/qad.0b013e328010943b
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发表时间：
2006-11-28
期刊：
影响因子：
3.8
通讯作者：
Msellati, Philippe
中科院分区：
文献类型：
--
作者：
Rouet, Francois;Fassinou, Patricia;Msellati, Philippe
背景：在非洲，面对HAART的推广，迫切需要准确监测这些终身治疗的长期效益。方法：对ANRS 1244/1278儿童队列（科特迪瓦阿比让）中的78名儿童的生存和免疫病毒学反应进行了评估，这些儿童从2000年10月开始接受HAART治疗，并随访至2004年9月。初始HAART包括两种核苷类逆转录酶抑制剂，奈非那韦（NFV）或依非韦伦（EFV）。为了比较免疫和病毒学反应，CD4细胞计数和HIV-1 RNA病毒载量通过进行时间点特异性和纵向数据分析进行评估。结果：基线时，中位CD4细胞百分比为7.5%，中位HIV-1 RNA病毒载量为5.37 log（10）拷贝/ml。生存率很高（第42个月时为0.86；95%可信区间为0.77-0.92），HAART方案是否含有NFV或EFV无差异。在随访36个月和42个月时，观察到免疫恢复，中位CD4细胞百分比分别达到23.1%和24.8%，根据HAART方案没有差异（纵向数据分析）。在同一时间点，也获得了持续的病毒抑制，无论是否采用HAART方案，无法检测到的病毒载量分别达到46.5%和45.0%。结论：这项研究证明了非洲儿童对HAART的临床和生物学反应的持久性。(c) 2006年Lippincott Williams & Wilkins。
Background: In Africa, facing the scaling-up of HAART, there is an urgent need to monitor accurately the long-term benefits of these lifelong treatments.Methods: Survival and immuno-virological response were assessed for 78 children in the ANRS 1244/1278 Children's cohort (Abidjan, Cote d'Ivoire) who were enrolled from October 2000 for treatment with HAART and followed to September 2004. Initial HAART consisted of two nucleoside reverse transcriptase inhibitors with either nelfinavir (NFV) or efavirenz (EFV). For the comparison of immunological and virological responses, CD4 cell counts and HIV-1 RNA viral load were assessed by performing time-point specific and longitudinal data analysis.Results: At baseline, the median CD4 cell percentage was 7.5% and the median HIV-1 RNA viral load was 5.37 log(10) copies/ml. The survival probability was high (0.86 at month 42; 95% confidence interval, 0.77-0.92) with no difference according to whether the HAART regimen contained NFV or EFV. At 36 and 42 months of follow-up, an immune recovery was observed with median CD4 cell percentages reaching 23.1% and 24.8%, respectively, with no difference according to the HAART regimen (longitudinal data analysis). At the same time points, a sustained viral suppression was also obtained, with undetectable viral load achieving in 46.5% and 45.0%, respectively, regardless of whether the HAART regimen.Conclusion: This study demonstrates the durability of both clinical and biological response to HAART in African children. (c) 2006 Lippincott Williams & Wilkins.