Abstract

ARANDA, Cinthia et al. Impact of Anti Retroviral Treatment (HAART) in Viral Suppression in Children Infected with Human Immunodeficiency Virus in Paraguay. Rev. Inst. Med. Trop. [online]. 2009, vol.4, n.1, pp.7-16. ISSN 1996-3696.

Background: Clinical trials have shown that HAART is able to reduce HIV plasma viral loads to undetectable in 70%-90% of patients (pts). HAART in developing countries is reported to be much less effective. Objectives: To evaluate the virologic response to HAART in children with HIV infection and to determine the factors associated to sustained decrease in the viral load. Material and methods: Retrospective, observational study that included pts< 17 years old infected with HIV before HAART and follow-up in a referral center of paediatric-HIV infection in Paraguay. Virologic responders were defined as those who either reached a viral load < 1000 copies/mL or had a >1.5 log reduction in viral load after week 12 of HAART initiation, which was maintained during the follow-up period. Results: 169 pts with HIV infection form the cohort of the institution, with a mean age of 7.5±3.8 years. 76 patients met the inclusion criteria. During the follow-up (85% of the pts with HAART =12 months), 48 pts (63%) achieved viral suppression whereas 28 (37%) do not. The viral load before the HAART were similar in both groups (50% and 43% of the pts with HIV-RNA >100.000 copies/ml) as well as in the CD4 count (35% vs. 43%). More pts in the non-responder group were female (60% vs.38%, p< 0.05). They were no differences between the age at HAART start, the current mean age, nutritional condition, percentage of orphans, and assistance to Day Care Center (DCC), between both groups. 42% in the responder-group were receiving protease-inhibitor vs. 8% of the non-responders (p< 0.05). Conclusions: The 37% of patients without HIV-1 suppression highlight need to be include a proteaseinhibitor based regimen as the first line treatment in developing countries

Keywords : developing countries; virologic response; infectology.

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