Sustained Immunologic and Virologic Efficacy After Four Years of Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus Infected Children in Thailand

Puthanakit, Thanyawee; Aurpibul, Linda; Oberdorfer, Peninnah; Akarathum, Noppadon; Kanjanavanit, Suparat; Wannarit, Pornphun; Sirisanthana, Thira; Sirisanthana, Virat

doi:10.1097/inf.0b013e318125720a

Cited by 46 publications

(45 citation statements)

References 10 publications

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“…There are seven QOL domains including: (1) health perception, (2) physical resilience, (3) physical functioning, (4) psychosocial well-being (for children 5-11 years old only), (5) social and role functioning, (6) health care utilization, and (7) symptoms. The raw scores in all seven domains had different minimum and maximum values, therefore, the raw scores were calculated to simple transformed scores of 0 to 100 with the following formula: transformed score = [(actual raw score -lowest possible raw score)/ (highest possible raw score -lowest possible raw score)] · 100].…”

Section: Quality Of Life Questionnaire and Transformed Scoresmentioning

confidence: 99%

“…[1][2][3] Currently, HIV-infected children treated with highly active antiretroviral therapy (HAART) have increased life expectancy. [4][5][6] Deaths related to HIV/AIDS mortality have decreased significantly, but the non-AIDSrelated conditions maintain a stable trend in children living with HIV-1 after treatment with HAART. 7 Unlike many other chronic illnesses, children with HIV infection are more likely to experience more difficulties in their daily lives (e.g., parental death from AIDS and social stigmatization 8,9 ) which may worsen their QOL.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Antiretroviral Therapy on Quality of Life in HIV-Infected Southeast Asian Children in the PREDICT Study

Bunupuradah

Kosalaraksa²,

Vibol³

et al. 2013

AIDS Patient Care and STDs

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Quality of life (QOL) is an important antiretroviral treatment (ART) outcome. We compared QOL among 299 Thai and Cambodian children ages 1-12 years-old, CD4 15-24% randomized to early (ART at week 0, N = 149) versus deferred groups (ART when at CD4 < 15%, N = 150) and also compared with QOL data from age-matched healthy controls (N = 275). Primary caregivers completed PACTG QOL questionnaires at week 0 and every 24 weeks until 144 weeks. Children were enrolled during March 2006 to September 2008. Mean (SD) age of children was 6.3 (2.8) years, 58% were female, 60% were Thai, %CDC N:A:B:C was 2:62:36:0%. During 144 weeks, all children in the early-group and 69 (46%) of deferred-group children started ART. There was no significant difference of QOL scores between treatment groups at baseline (all p > 0.05) and at week 144 (all p > 0.05). By multivariate analysis, the early-group had higher QOL score changes in five domains, including health perception ( p = 0.04), physical resilience ( p = 0.02), psychosocial well-being ( p = 0.04), social and role functioning ( p < 0.01), and symptoms ( p = 0.01) compared to the deferred group. QOL of HIV-infected children in both groups were lower than healthy control in all 7 domains at baseline (all p < 0.05) and 5 of 7 domains at weeks 144 ( p < 0.01). In conclusion, no significant difference of QOL scores between treatment groups. Early ART commencement associated with greater increase of QOL scores over 144 weeks. QOL scores in HIV-infected children were lower than healthy controls.

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Section: Quality Of Life Questionnaire and Transformed Scoresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of Antiretroviral Therapy on Quality of Life in HIV-Infected Southeast Asian Children in the PREDICT Study

Bunupuradah

Kosalaraksa²,

Vibol³

et al. 2013

AIDS Patient Care and STDs

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“…2,3 In the last decade, highly active antiretroviral treatment (ART) has significantly improved the virologic, immunologic, and clinical outcomes in both adults and children. [4][5][6] Many studies from developed countries using protease inhibitor (PI)-based ART regimen showed an improvement in growth of HIV-infected children after initiating ART. [7][8][9] Studies from Kenya and Uganda also showed significant improvements in weight and height as well as immunological and virologic parameters of perinatally HIVinfected children after ART initiation.…”

mentioning

confidence: 99%

Reversal of Growth Failure in HIV-Infected Thai Children Treated with Non-Nucleoside Reverse Transcriptase Inhibitor–Based Antiretroviral Therapy

Aurpibul

Puthanakit

Taecharoenkul

et al. 2009

AIDS Patient Care and STDs

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Growth failure is a common problem in HIV-infected children. The extent to which this growth failure could be reversed after the children receive antiretroviral therapy (ART) is not known. This study assessed the incidence of growth failure in HIV-infected Thai children, impact of ART on growth, and the predictors of growth reversal after initiating ART. Growth parameters and other characteristics were extracted from the database of a prospective cohort of HIV-infected children (age 15 years) who were enrolled to initiate non-nucleoside reverse transcriptase inhibitor-based ART between August 2002 and May 2007. Body weight and height measurements, CD4 cell counts, plasma HIV RNA levels were collected at baseline and 24-week intervals. A total of 225 HIV-infected children were included, 116 (51%) were males. The median age at baseline was 7.4 years (interquartile range [IQR] 5.2-9.8). Fifty-three percent were in Centers for Disease Control and Prevention (CDC) category C and 54% had CD4 percentage 5 or less. The mean (standard deviation [SD]) of baseline weight-for-age (WAZ) and height-forage (HAZ) z-scores were À2.02 (1.17) and À2.22 (1.51). The median follow-up time was 216 weeks (IQR 120-240). The cumulative probability of growth reversal among the 179 subjects with growth failure at entry was 58% (95% confidence interval [CI] 49-67) at week 240. In a multivariate Cox regression model, higher entry WAZ ( p < 0.001) and HAZ ( p < 0.001), use of a nevirapine-based regimen (compared to efavirenz, p ¼ 0.027) and larger CD4% gains to week 48 ( p < 0.001) were significant predictors of growth reversal after initiating ART. NNRTI-based ART leads to a substantial improvement in growth of HIV-infected children. Initiation of ART before the children developed growth failure should be encouraged.

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“…Successful virological response has been reported variously, as < 50 [15,23], < 400 [16,21,24] or < 1000 copies/mL [25] in different parts of the world. Based on these cut-offs, response rates of 55% (two months) in China [24] , 74% in Cambodia [16], and 69% (three months) and 70% (two years) in Thailand have been reported [15].…”

Section: Discussionmentioning

confidence: 99%

“…Higher baseline CD4 values and use of NNRTIbased regimens rather than PI-based are two important predictors of faster immunologic recovery [15,[21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Clinical manifestations and treatment outcomes in HIV-1-infected children receiving antiretroviral therapy in Karachi, Pakistan

Mir

Qamar

Baig‐Ansari

et al. 2014

J Infect Dev Ctries

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Introduction: The impact of antiretroviral (ARV) therapy on immunological and growth parameters in HIV-positive children in Pakistan has not been reported to date. Methodology: A retrospective chart review of children diagnosed with HIV at the Sindh AIDS Control Proigramme (SACP) and registered at the Aga Khan University, Karachi, between January 2005 and 2013 was conducted, evaluating clinical and laboratory profiles of HIV+ ARV+ children for ARV impact (serial height and weight CD4 and viral counts). Results: Twenty-four children were diagnosed and registered as HIV positive over five years, and 20 were started on ARV. Six were excluded from analysis (ARV duration < 6 months). Nine (64.3%) of 14 fulfilled WHO criteria for treatment failure at a median duration of 25 weeks (IQR 18-32) on ARV and underwent resistance genotyping. All nine had NNRTI resistance, two had high-grade NRTI resistance (≥ 4 thymidine analog mutations). Median age at start of ARV was 71.5 weeks (IQR 37.5-119). Median baseline weight for age (WAZ) and height for age (HAZ) z-scores changed from -1.94 to 1.69 and -1.99 to -1.59, respectively, after six months of therapy. Median CD4 percentage and viral load at baseline changed from 13.8 to 17.8, while viral load changed from 285 × 10 4 copies to zero at six months. Conclusions: ARV improved absolute CD4 and viral counts. Weight and height did not improve significantly, highlighting the need for aggressive nutritional rehabilitation. Early development of ARV resistance in these children requires formal assessment.

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Sustained Immunologic and Virologic Efficacy After Four Years of Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus Infected Children in Thailand

Cited by 46 publications

References 10 publications

Impact of Antiretroviral Therapy on Quality of Life in HIV-Infected Southeast Asian Children in the PREDICT Study

Impact of Antiretroviral Therapy on Quality of Life in HIV-Infected Southeast Asian Children in the PREDICT Study

Reversal of Growth Failure in HIV-Infected Thai Children Treated with Non-Nucleoside Reverse Transcriptase Inhibitor–Based Antiretroviral Therapy

Clinical manifestations and treatment outcomes in HIV-1-infected children receiving antiretroviral therapy in Karachi, Pakistan

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