Resumo

ARANDA, Cinthia, OVELAR, Patricia, AGUAYO, Nicolás et al. Impacto del Tratamiento Antirretroviral de Gran Actividad (TARGA) en la Supresión Viral en Niños Infectados por el Virus de Inmunodeficiencia Humana en Paraguay. Rev. Inst. Med. Trop., jul. 2009, vol.4, no.1, p.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

Palavras-chave: developing countries; virologic response; infectology.