Berhan Yifru
Department of Gynecology, Hawassa University, P.o.box 1560.
Ethiop Med J. 2011 Oct;49(4):289-98.
Although antiretroviral treatment (ART) programmes began in 2003 in Ethiopia, there is scarcity of information about paediatric ART.
The purpose of this study was to describe the changes in absolute CD4 counts among children on ART METHODS: A multicenter retrospective cohort assessment was applied to analyze 336 HIV-infected children who were under 15 years old and on ART (September 2006 - March 2009) using a sample database from seven public hospitals in different regions.
The mean age at the time of ART commencement of the cohort were 5.9 +/- 3.2 years. Median follow-up of the cohort was 12 (Inter quartile range 6 to 18) months. The overall absolute CD4 count change showed an increasing trend from the baseline in all age categories. At age 5 years and above, the baseline CD4 count was very low but the increment was very high up to 12 months. The mean absolute CD4 count change in relation to the duration of ART showed an increasing trend up to 12 months and declined after 18 and 24 months. Severe immunosuppression (SI) at initiation of ART (P < 0.0001; Adjusted OR, 5.3) and age 3-4.9 years were independent predictors of continuing SI up to 6 months. Only SI at 6 months was independently associated with SI at 12 months (P < 0.0001; AOR, 21.4).
The majority of children have CD4 count rise after ART and that the slope of rise was greater in older children in the first 12 months of therapy.
尽管埃塞俄比亚于2003年启动了抗逆转录病毒治疗（ART）项目，但关于儿童抗逆转录病毒治疗的信息却很匮乏。
本研究旨在描述接受抗逆转录病毒治疗的儿童绝对CD4细胞计数的变化。
采用多中心回顾性队列评估，利用来自不同地区七家公立医院的样本数据库，分析336名15岁以下接受抗逆转录病毒治疗的HIV感染儿童（2006年9月至2009年3月）。
该队列开始接受抗逆转录病毒治疗时的平均年龄为5.9±3.2岁。队列的中位随访时间为12个月（四分位间距为6至18个月）。所有年龄组的总体绝对CD4细胞计数变化均显示从基线开始呈上升趋势。5岁及以上儿童的基线CD4细胞计数非常低，但到12个月时增幅非常大。与抗逆转录病毒治疗持续时间相关的平均绝对CD4细胞计数变化在12个月前呈上升趋势，在18个月和24个月后下降。开始抗逆转录病毒治疗时的严重免疫抑制（SI）（P<0.0001；调整后的OR，5.3）和3至4.9岁年龄是持续6个月SI的独立预测因素。仅6个月时的SI与12个月时的SI独立相关（P<0.0001；AOR，21.4）。
大多数儿童在接受抗逆转录病毒治疗后CD4细胞计数上升，且在治疗的前12个月中，年龄较大儿童的上升斜率更大。
