Wanless Richard S B, Rugină Sorin, Ruţă Simona Maria, Dumitru Irina-Magdalena, Cernat Roxana Carmen, Schwarzwald Heidi L, Calles Nancy R, Schutze Gordon E, Schweitzer Ana-Maria, Draper Heather R, Kline Mark W
MB, ChB, PhD, Baylor College of Medicine International Pediatric AIDS Initiative, Texas Children's Hospital, Houston, Texas, USA.
MD, PhD, Ovidius University of Constanţa; Clinical Hospital of Infectious Diseases, Constanţa, Romania.
Germs. 2013 Sep 1;3(3):90-5. doi: 10.11599/germs.2013.1042.
Many Romanian children were infected nosocomially with human immunodeficiency virus (HIV) in the late 1980s. The Romanian-American Children's Center of Excellence in Constanţa continues to follow approximately 450 of these patients. In 2001, 414 of these patients were initiated on triple therapy including lopinavir/ritonavir. Data from this cohort treated through August 2006 were published in April 2007 demonstrating that the treatment was well tolerated, with 337 children (81%) remaining on therapy after a median duration of >4 years. The current article describes the results of continued analysis of this cohort through end 2010. The objective of the study was to determine the long-term clinical outcomes of children and adolescents commenced on antiretroviral therapy (ART) including lopinavir/ritonavir.
Data were extracted retrospectively from the charts of the 336 patients remaining on lopinavir/ritonavir in August 2006. The following outcomes were analyzed: mortality, current patient status, viral load (VL), CD4 counts and reasons for discontinuation of lopinavir/ritonavir.
The median age at initiation of lopinavir/ritonavir was 14.0 years (range 5.4 to 20.0 years). The median time on lopinavir/ritonavir treatment was 7.5 years (interquartile range 5.7 to 8.6 years). Overall mortality was 13.5%. Of the original 414 patients started on lopinavir/ritonavir in 2001, 199 (48.1%) remained on this therapy at the end of 2010 and of these 63.8% had undetectable viral load.
Despite initial suboptimal ART, a significant proportion of patients subsequently treated with a lopinavir/ritonavir based regimen remained on this therapy for up to nine years.
20世纪80年代末，许多罗马尼亚儿童在医院感染了人类免疫缺陷病毒（HIV）。康斯坦察的罗马尼亚裔美国儿童卓越中心继续对其中约450名患者进行随访。2001年，这些患者中有414人开始接受包括洛匹那韦/利托那韦在内的三联疗法。截至2006年8月治疗的该队列数据于2007年4月发表，表明该治疗耐受性良好，中位治疗时间>4年后，337名儿童（81%）仍在接受治疗。本文描述了对该队列持续至2010年底的分析结果。该研究的目的是确定开始接受包括洛匹那韦/利托那韦在内的抗逆转录病毒疗法（ART）的儿童和青少年的长期临床结局。
回顾性提取2006年8月仍在接受洛匹那韦/利托那韦治疗的336名患者的病历数据。分析了以下结局：死亡率、当前患者状态、病毒载量（VL）、CD4细胞计数以及停用洛匹那韦/利托那韦的原因。
开始使用洛匹那韦/利托那韦治疗时的中位年龄为14.0岁（范围5.4至20.0岁）。接受洛匹那韦/利托那韦治疗的中位时间为7.5年（四分位间距5.7至8.6年）。总死亡率为13.5%。2001年开始使用洛匹那韦/利托那韦治疗的414名患者中，199名（48.1%）在2010年底仍在接受该治疗，其中63.8%的患者病毒载量检测不到。
尽管最初的抗逆转录病毒疗法并非最佳，但随后接受基于洛匹那韦/利托那韦方案治疗的相当一部分患者在该疗法上持续治疗了长达九年。
