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Antiretroviral use in Italian children with perinatal HIV infection over a 14-year period.
- Source :
-
Acta paediatrica (Oslo, Norway : 1992) [Acta Paediatr] 2012 Jul; Vol. 101 (7), pp. e287-95. Date of Electronic Publication: 2012 Apr 04. - Publication Year :
- 2012
-
Abstract
- Background: Information on the use of new antiretroviral drugs in children in the real setting of clinical fields is largely unknown.<br />Methods: Data from 2554 combined antiretroviral therapy (cART) regimens administered to 911 children enrolled in the Italian Register for HIV infection in children, between 1996 and 2009, were analysed. Factors potentially associated with undetectable viral load and immunological response to cART were explored by Cox regression analysis.<br />Results: Proportion of protease inhibitor (PI)-based regimens significantly decreased from 88.0% to 51.2% and 54.9%, while proportion on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens increased from 4.5% to 38.8% and 40.2% in 1996-1999, 2000-2004 and 2005-2009, respectively (p < 0.0001). Significant change in the use of each antiretroviral drug occurred over the time periods (p < 0.0001). Factors independently associated with virological and immunological success were as follows: later calendar periods, younger age at regimen (only for virological success) and higher CD4(+) T-lymphocyte percentage at baseline. Use of unboosted PI was associated with lower adjusted hazard ratio (aHR) of virological or immunological success with respect to NNRTI- and boosted PI-based regimens, with no difference among these two latter types.<br />Conclusion: Use of new generation antiretroviral drugs in Italian HIV-infected children is increasing. No different viro-immunological outcomes between NNRTI- and boosted PI-based cART were observed.<br /> (© 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.)
- Subjects :
- Adolescent
Age Factors
Antiretroviral Therapy, Highly Active statistics & numerical data
Antiretroviral Therapy, Highly Active trends
Child
Child, Preschool
Female
HIV Infections immunology
HIV Infections transmission
HIV Infections virology
Humans
Infant
Infant, Newborn
Infectious Disease Transmission, Vertical
Italy
Male
Multivariate Analysis
Proportional Hazards Models
Registries
Treatment Outcome
Viral Load
HIV Infections drug therapy
HIV Protease Inhibitors therapeutic use
Reverse Transcriptase Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1651-2227
- Volume :
- 101
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Acta paediatrica (Oslo, Norway : 1992)
- Publication Type :
- Academic Journal
- Accession number :
- 22452359
- Full Text :
- https://doi.org/10.1111/j.1651-2227.2012.02675.x