Response to highly active antiretroviral therapy varies with age: the UK and Ireland Collaborative HIV Paediatric Study.

Journal article

OBJECTIVE: To evaluate the effect of age, CD4 percentage (CD4%) and plasma HIV-1 RNA on response to highly active antiretroviral therapy (HAART) in previously untreated children. DESIGN: Cohort study. METHODS: We examined the association between age at HAART initiation, and CD4 and HIV-1 RNA response using logistic and Cox regression, adjusting for sex, route of infection and pre-HAART values. RESULTS: CD4% increases of > 10% at 6 months were more likely in younger children [odds ratio (OR), 0.84 per year, P < 0.001] and those with lower pre-HAART CD4% (OR, 0.67 per 5% higher, P < 0.001), but were not related to pre-HAART HIV-1 RNA (P = 0.6). In contrast, HIV-1 RNA suppression < 400 copies/ml at 6 months was more likely in older children (OR, 1.09 per year, P = 0.03), and was unrelated to pre-HAART HIV-1 RNA or CD4% (P > 0.3). CD4% was still increasing during the second year following HAART initiation (60% followed > 24 months). Longer-term increases in CD4% occurred faster, and decreases in HIV-1 RNA occurred more slowly in younger children. The median time to CD4% >/= 30% after initiating HAART with CD4%

Authors: Walker, A; Doerholt, K; Sharland, M; Gibb, D

• Publication status: Published
• Journal: AIDS (London, England)
• Volume: 18
• Issue: 14
• Pages: 1915-1924
• Publication date: 2004-09-01
• DOI: 10.1097/00002030-200409240-00007
• EISSN: 1473-5571
• ISSN: 0269-9370
• Language: English
• Keywords: HIV-1; HIV Infections; Cohort Studies; Ireland; Great Britain; Antiretroviral Therapy, Highly Active; Viral Load; RNA, Viral; Age Factors; Humans; Child; CD4 Lymphocyte Count; Infant; Infant, Newborn; Child, Preschool; CD4-Positive T-Lymphocytes; Collaborative HIV Paediatric Study (CHIPS) Steering Committee