Musoke Philippa M, Barlow-Mosha Linda, Bagenda Danstan, Mudiope Peter, Mubiru Michael, Ajuna Patrick, Tumwine James K, Fowler Mary Glenn
Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda.
J Acquir Immune Defic Syndr. 2009 Dec;52(5):560-8. doi: 10.1097/qai.0b013e3181b93a5a.
To compare the response to a nevirapine (NVP)-based highly active antiretroviral therapy (HAART) in HIV-infected Ugandan children, exposed and nonexposed to single-dose NVP (sd NVP) at birth.
HIV-infected study children were initiated on stavudine/lamivudine/NVP as a fixed dose combination. CD4 cell percent and HIV-1 RNA were documented at baseline, 12, 24, 36, and 48 weeks post-initiation of HAART.
Ninety-two children were enrolled in the study, 44 in the sd NVP-exposed and 48 in the nonexposed cohort. The median age at enrollment was 1.7 years [interquartile range (IQR) 1.2-2.4] and 7.8 years (IQR 5.9-9.2) in the sd NVP-exposed and nonexposed cohorts,respectively (P < 0.001). At baseline and week 48 post-HAART, the median CD4 cell percentages were 14% and 33% for the NVP-exposed group and 8% and 22.5% in the nonexposed group (P < 0.0001). The median (IQR) viral load at baseline was 650,568 (359,979-2,086,613) RNA copies/mL and 239,027 (105,904-494,813) RNA copies/mL in the NVP-exposed and nonexposed cohorts, respectively. After 48 weeks of HAART, 76% of the NVP-exposed and 80% of the nonexposed children had a median viral load of < 400 copies/mL (P = 0.74).
Both HIV-infected Ugandan older infants and children that were exposed and not exposed to sd NVP at birth had favorable treatment outcomes on NVP-containing HAART.
比较在乌干达感染HIV的儿童中，出生时暴露于和未暴露于单剂量奈韦拉平（sd NVP）的儿童对基于奈韦拉平（NVP）的高效抗逆转录病毒疗法（HAART）的反应。
感染HIV的研究儿童开始使用司他夫定/拉米夫定/NVP固定剂量组合治疗。在HAART开始后的基线、12周、24周、36周和48周记录CD4细胞百分比和HIV-1 RNA。
92名儿童参与了该研究，44名暴露于sd NVP，48名未暴露。暴露组和未暴露组入组时的中位年龄分别为1.7岁[四分位间距（IQR）1.2 - 2.4]和7.8岁（IQR 5.9 - 9.2）（P < 0.001）。在基线和HAART后48周，暴露于NVP组的中位CD4细胞百分比分别为14%和33%，未暴露组为8%和22.5%（P < 0.0001）。暴露组和未暴露组基线时的中位（IQR）病毒载量分别为650,568（359,979 - 2,086,613）RNA拷贝/毫升和239,027（105,904 - 494,813）RNA拷贝/毫升。HAART 48周后，76%暴露于NVP的儿童和80%未暴露的儿童中位病毒载量< 400拷贝/毫升（P = 0.74）。
出生时暴露和未暴露于sd NVP的乌干达感染HIV的大龄婴儿和儿童在含NVP的HAART治疗中均有良好的治疗效果。
