Department of Paediatrics, Pietermarizburg Metropolitan Hospitals Complex, Pietermaritzburg, 3200, South Africa.
J Trop Pediatr. 2012 Apr;58(2):114-9. doi: 10.1093/tropej/fmr053. Epub 2011 Jun 24.
A recent randomized trial showed dramatic improvement in survival of HIV-infected infants receiving early combination antiretroviral therapy (cART). However, few data are available for resource-limited settings. Therefore we conducted a chart review of HIV-infected infants initiated on cART between 2005 and 2008. Of 129 treated infants, 94 completed 6 months, 62 completed 12 months, and 39 completed 18 months of cART. Median age at initiation of cART was 8.6 months (range 2.1-11.9) and 77.2% had advanced disease. Undetectable VL was found in 78.8% of children who reached 18 months of treatment. CD4% increased from a median of 15.4% at baseline to 33.1% at 18 months. Weight for age Z-score increased from a mean ± SD of -2.7 ± 1.97 to 0.02 ± 1.10 at 18 months. Findings show favourable response to cART in HIV-infected infants outside a research environment, despite initial advanced disease. Efforts should be made to initiate cART as early as possible.
一项近期的随机试验显示，接受早期联合抗逆转录病毒治疗（cART）的 HIV 感染婴儿的存活率显著提高。然而，在资源有限的环境中，可用的数据很少。因此，我们对 2005 年至 2008 年间接受 cART 治疗的 HIV 感染婴儿进行了图表回顾。在 129 名接受治疗的婴儿中，94 名完成了 6 个月的治疗，62 名完成了 12 个月的治疗，39 名完成了 18 个月的治疗。开始 cART 的中位年龄为 8.6 个月（范围 2.1-11.9），77.2%的婴儿患有晚期疾病。在达到 18 个月治疗的儿童中，有 78.8%的儿童病毒载量不可检测。CD4%从基线时的中位数 15.4%增加到 18 个月时的 33.1%。体重与年龄 Z 评分从平均±SD 的-2.7±1.97增加到 18 个月时的 0.02±1.10。研究结果表明，在研究环境之外，HIV 感染婴儿对 cART 有良好的反应，尽管最初患有晚期疾病。应努力尽早开始 cART。
