Virologic, immunologic, and clinical benefits from early combined antiretroviral therapy in infants with perinatal HIV-1 infection.
Virologic, immunologic, and clinical benefits from early combined antiretroviral therapy in infants with perinatal HIV-1 infection.
复制标题
DOI：
10.1097/01.aids.0000200529.64113.3e
复制
发表时间：
2006-01-09
期刊：
影响因子：
3.8
通讯作者：
de Martino, M
中科院分区：
文献类型：
--
作者：
Chiappini, E;Galli, L;de Martino, M
目的：探讨早期与延迟联合抗逆转录病毒治疗（ART）在无症状或中度症状[疾病控制和预防中心（CDC）类别N，A或B]的围产期HIV-1 infection.Methods婴儿的影响：进行了一项多中心的全国性病例对照研究。将30名在6个月龄前接受三种或三种以上药物联合抗逆转录病毒治疗的婴儿的数据与103名在6个月龄后开始接受三种或三种以上药物联合抗逆转录病毒治疗的婴儿的数据进行比较。中位随访时间为4.1年（范围，1.0-6.5年）。结果：两组儿童的首次可用病毒载量和CD 4 T淋巴细胞百分比无明显差异。在所有随访期间，早期治疗的婴儿的病毒载量明显低于接受延迟治疗的婴儿。早期治疗的婴儿达到不可检测病毒载量的比例高于接受延迟治疗的婴儿（73.3%对30.1%; P < 0.0001）。在1324（P < 0.0001）、25-36（P <0.0001）和37-48（P = 0.003）月龄时，早期治疗婴儿的CD 4 T淋巴细胞百分比较高。没有早期治疗的婴儿与20/103（19.4%）的婴儿接受延迟ART（P = 0.02）显示在随访期间的一个时间点的CD 4 T淋巴细胞百分比低于15%。在随访期间，早期治疗的婴儿没有发生CDC A、B或C类临床事件，而103例接受延迟治疗的婴儿中有44例（42.7%）的CDC类别下降。Kaplan-Meier分析显示CDC分类A（P = 0.0002），B（P = 0.0003）和C（P = 0.0018）无事件survivals.Conclusion的显着差异：该数据表明病毒学，免疫学和早期管理ART的临床效益。（C）2006 Lippincott威廉姆斯& Wilkins。
Objective: To investigate the impact of early versus deferred combined antiretroviral treatment (ART) in asymptomatic or moderately symptomatic [Centers for Disease Control and Prevention (CDC) category N, A or B] infants with perinatal HIV-1 infection.Methods: A multi-centre nationwide case-control Study was conducted. Data from 30 infants treated with combined ART with three or more drugs before 6 months of age were compared with data from 103 infants starting ART with three or more drugs after 6 months of age. The median follow-up time was 4.1 years (range, 1.0-6.5 years).Results: No difference was evident in the first available viral load and CD4 T-lymphocyte percentage between the two groups of children. Early-treated infants showed significantly lower viral loads than infants receiving deferred treatment at all the follow-up periods. A higher proportion of early-treated infants than infants receiving deferred treatment (73.3% versus 30.1 %; P < 0.0001) reached an undetectable viral load. Higher CD4 T-lymphocyte percentages were found in early-treated infants at 1324 (P < 0.0001), 25-36 (P < 0.0001), and 37-48 (P = 0.003) months of age. No early-treated infant versus 20 of 103 (19.4%) infants receiving deferred ART (P = 0.02) showed a CD4 T-lymphocyte percentage of less than 15% at one time point during follow-up. No CDC category A, B or C clinical event Occurred in early-treated infants over the follow-up period while 44 of 103 (42.7%) infants receiving deferred treatment presented a decline in the CDC category. Kaplan-Meier analyses revealed significant differences in CDC category A (P = 0.0002), B (P = 0.0003), and C (P = 0.0018) event-free survivals.Conclusion: The data suggest virologic, immunologic, and clinical benefits from early administration of ART. (C) 2006 Lippincott Williams & Wilkins.