Effect of Combination Therapy Including Protease Inhibitors on Mortality among Children and Adolescents Infected with HIV-1

Gortmaker, Steven L.; Hughes, Michael D.; Cervia, Joseph S.; Brady, Michael T.; Johnson, George M.; Seage, George R.; Song, Lin; Dankner, Wayne M.; Oleske, James M.

doi:10.1056/nejmoa011157

Cited by 451 publications

(290 citation statements)

References 27 publications

Supporting

Mentioning

264

Contrasting

Unclassified

Order By: Relevance

“…In our study, the HAART therapy has allowed for a better cellular immunity due to a significant increase in the count of CD4+ lymphocytes in both age ranges, and such fact was also observed by other authors 4,5,25,26 . This may have been one of the reasons that led the children under HAART, aged bellow 6 years to present lower COM incidence.…”

Section: Chronic Otitis Mediasupporting

confidence: 89%

“…In Brazil, until December of 2004, about 13,786 cases of children bellow 13 years of age had been registered by the Ministry of Health 2 . The discovery of new antiretroviral drugs, specially protease inhibitors have substantially reduced mortality and increased the life expectancy of these children 3,4 . Such condition, associated to the fact that many of the initial signs and symptoms of HIV infections are otorhinolaryngological, has brought a greater number of these patients to be assessed by this medical specialty 3,5 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impacto da Haart na prevalência de otite média crônica em crianças brasileiras infectadas pelo HIV

Weber

Pinheiro‐Neto

Miziara

et al. 2006

Rev. Bras. Otorrinolaringol.

View full text Add to dashboard Cite

O advento de novas drogas anti-retrovirais como os inibidores de protease provocou mudanças sensíveis na morbidade e mortalidade de pacientes infectados pelo HIV. OBJETIVOS: Avaliar o impacto das novas drogas anti-retrovirais (Highly Active Anti-retroviral Therapy - HAART) na prevalência de otite média crônica em população pediátrica infectada pelo HIV. MÉTODOS: Analisamos os prontuários de 471 crianças com idade entre zero e 12 anos e 11 meses portadoras de HIV atendidas no ambulatório de AIDS de Clínica Otorrinolaringológica do HCFMUSP. As crianças foram divididas em dois grupos, de acordo com a faixa etária: 0 a 5 anos e 11 meses e 6 a 12 anos e 11 meses, e classificadas como portadoras de otite média crônica, baseadas em achados de anamnese, otoscopia, audiometria e imitanciometria. As prevalências de otite média crônica apresentadas e as contagens de linfócitos T CD4+ foram comparadas entre as crianças em uso ou não de HAART. RESULTADOS: Das 459 crianças atendidas, 65 (14,2%) apresentavam otite média crônica. Observamos, nas crianças de 0 a 5 anos e 11 meses que o uso de HAART esteve associado a significante menor prevalência de otite média crônica (p = 0,02), e maior contagem de linfócitos T CD4+ (p < 0,001). CONCLUSÃO: O uso de HAART esteve associado à menor prevalência da forma crônica de otite média entre crianças menores de 6 anos infectadas pelo HIV, provavelmente como conseqüência do aumento promovido na contagem de linfócitos T CD4+.

show abstract

Section: Chronic Otitis Mediasupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Impacto da Haart na prevalência de otite média crônica em crianças brasileiras infectadas pelo HIV

Weber

Pinheiro‐Neto

Miziara

et al. 2006

Rev. Bras. Otorrinolaringol.

View full text Add to dashboard Cite

show abstract

“…given rise to a new topic of discussion among professionals who care for this population: transitioning adolescents who were treated by pediatricians throughout their lives to Transitioning adolescents living with HIV/AIDS to adult-oriented health care: an emerging challenge Daisy Maria Machado, 1 Regina C. Succi, 2 Egberto Ribeiro Turato 3 adult-oriented health care services. This transition has been beset by challenges of various natures, such as structural and organizational issues in health care services, social issues, and issues associated with the psychological and cultural sense and significance of transitioning from youth to adulthood.…”

Section: This New Picture Of Hiv/aids As a Chronic Disease Hasmentioning

confidence: 99%

“…1 This scenario was made possible by the advent of highly active antiretroviral therapy (HAART), which, alongside various prophylactic measures, has decreased morbidity and mortality rates in this group. [2][3][4][5] In Brazil, 11,607 cases of childhood AIDS due to motherto-child transmission were reported between the years of 1980 and 2008. 6 Clinical observation and follow-up of this population has shown that, as the HIV/AIDS wears on, the challenges faced by care providers and patients have also changed.…”

Section: Introductionmentioning

confidence: 99%

A transição de adolescentes com HIV/AIDS para a clínica de adultos: um novo desafio

Machado¹,

Succi²,

Turato³

2010

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Objective: To review the literature on transition from pediatric to adult-oriented health care and discuss this issue in the specific context of chronic conditions. Sources: MEDLINE and LILACS were searched for relevant English and French-language articles published between 1990 and 2010. Summary of the findings:The transition of adolescents with chronic diseases from pediatric care to adultoriented services has been a growing concern among pediatric specialties. In recent years, young people living with HIV/AIDS have begun to reach adulthood, giving rise to several challenges. The studies reviewed herein discuss such relevant topics as: the difference between transfer, an isolated event, and transition, a gradual process; the transition models used in different services; the importance of transitioning in a planned and individualized manner; the need for comprehensive interaction between pediatric and adult-oriented care teams; the importance of joint participation of adolescents, their families, and health professionals in the process; barriers to and factors that promote successful transitions; and the special needs of adolescents with HIV/AIDS in this important period of life. Conclusions:Several authors agree that transitioning adolescents to adult-oriented health care should be a gradual process not determined by age alone. It requires a plan established with ample dialogue among adolescents, their families, and pediatric and adult care teams. However, there is little evidence to support any specific model of health care transition. This should prompt researchers to conduct more prospective studies on the theme, especially in more vulnerable groups such as adolescents living with HIV/AIDS.

show abstract

“…[10][11][12] Combined therapy improved the prognosis of AIDS by increasing the life expectancy of adults and children. [13][14][15] However, after careful consideration, the guidelines for ARV therapy had to be changed at the beginning of the third decade of the HIV/AIDS pandemics. The combination of available ARV drugs for highly active antiretroviral therapy (HAART) could not eradicate the HIV, and the suppression of viral replication was not always achieved.…”

Section: Introductionmentioning

confidence: 99%

Efetividade da terapia anti-retroviral dupla e tríplice em crianças infectadas pelo HIV

Romanelli¹,

Pinto²,

Melo³

et al. 2006

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Objective: The use of antiretroviral therapy in HIV-infected children has been a widely discussed issue. The aim of this study was to compare the effectiveness of dual nucleoside analogue reverse transcriptase inhibitor (NRTI) regimens and three-drug regimens [2NRTI+ non-nucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI)] in a cohort of HIV-infected children. Methods:The study was carried out in a referral center for the management of infected children, which is affiliated with the School of Medicine of Universidade Federal de Minas Gerais (UFMG). Those children whose antiretroviral therapy was implemented between January 1998 and December 2000 and who were followed until December 2001 were included in the study. Therapeutic failure or death was regarded as the endpoint in our analysis.Results: A total of 101 patients were assessed, 58 (57.4%) on dual therapy and 43 (42.6%) on triple therapy. No statistically significant difference was observed between the groups in terms of gender, age, CD4+ count and baseline viral load. The average duration of dual therapy was 26.3 months (95%CI 21.3-31.3) and that of triple therapy was 34.3 months (95%CI 29.2-39.5%). There was therapeutic failure in 33 (56.9%) patients on dual therapy and in 11 (25.6%) patients on triple therapy (log rank = 5.03; p = 0.025). The relative risk of therapeutic failure of the dual therapy was 2.2 times higher (95%CI 1.3-3.9). The percentage of initial CD4+ T cells was a predictor of risk for therapeutic failure (p = 0.001). Patients on triple therapy showed a more remarkable reduction in their viral load (p = 0.001). Conclusion:Triple therapy was efficient for a longer time period and showed better virologic response than dual therapy in this cohort of HIV-infected children. Therefore, triple therapy should be the treatment of choice.

show abstract

Effect of Combination Therapy Including Protease Inhibitors on Mortality among Children and Adolescents Infected with HIV-1

Abstract: The use of combination therapy including protease inhibitors has markedly reduced mortality among children and adolescents infected with HIV-1.

Cited by 451 publications

References 27 publications

Impacto da Haart na prevalência de otite média crônica em crianças brasileiras infectadas pelo HIV

Impacto da Haart na prevalência de otite média crônica em crianças brasileiras infectadas pelo HIV

A transição de adolescentes com HIV/AIDS para a clínica de adultos: um novo desafio

Efetividade da terapia anti-retroviral dupla e tríplice em crianças infectadas pelo HIV

Contact Info

Product

Resources

About