Kokeb Mehretie, Degu Getu
Department of Pediatrics and Child Health, University of Gondar, Ethiopia.
Department of Epidemiology and Biostastics, University of Gondar, Ethiopia.
Ethiop J Health Sci. 2016 Jan;26(1):25-30. doi: 10.4314/ejhs.v26i1.6.
The effectiveness of highly active antiretroviral therapy (HAART) in children has not been well studied specially in developing countries where the burden of HIV is high. This study was aimed to assess the immunologic response of HIV-infected children to HAART at Pediatric ART Clinic Gondar University Hospital.
Institution based cross-sectional study was conducted at the Pediatric ART Clinic Gondar University Hospital from March 01-April 30, 2014. The study included 283 HIV-infected children who were on HAART for 6 months and above. Medical records of HIV-infected children were reviewed using pre-tested questionnaire. CD4 count/percent was collected every 6 months retrospectively. For all statistical significance tests, the cut-off value was p<0.05. Poison Regression was used for further analysis.
The mean age of children was 6.9 years with a standard deviation of 3.4 years. The median CD4 count/percent was 232/13%, 450/21%, 540/25% and 608/27% at the time of initiation, 6, 12 and 18 months of ART, respectively. HAART initiated at higher CD4 count, good adherence and HIV status disclosure were found to have positive effects for immunological response.
The study revealed that there was good Immunological response to ART, and that the maximum response was in the 1(st) 6 months of ART. Low CD4 count at initiation, undisclosed HIV status and lack of good adherence were found to cause low immunological response to HAART.
高效抗逆转录病毒疗法(HAART)在儿童中的有效性尚未得到充分研究,特别是在艾滋病毒负担较高的发展中国家。本研究旨在评估贡德尔大学医院儿科抗逆转录病毒治疗诊所中感染艾滋病毒儿童对HAART的免疫反应。
2014年3月1日至4月30日在贡德尔大学医院儿科抗逆转录病毒治疗诊所进行了基于机构的横断面研究。该研究纳入了283名接受HAART治疗6个月及以上的感染艾滋病毒儿童。使用预先测试的问卷对感染艾滋病毒儿童的病历进行了审查。回顾性收集每6个月的CD4细胞计数/百分比。对于所有统计学显著性检验,临界值为p<0.05。采用泊松回归进行进一步分析。
儿童的平均年龄为6.9岁,标准差为3.4岁。在开始抗逆转录病毒治疗时、治疗6个月、12个月和18个月时,CD4细胞计数/百分比的中位数分别为232/13%、450/21%、540/25%和608/27%。发现开始HAART时CD4细胞计数较高、依从性良好和披露艾滋病毒感染状况对免疫反应有积极影响。
该研究表明,对抗逆转录病毒治疗有良好的免疫反应,且最大反应出现在抗逆转录病毒治疗的第1个6个月。发现开始治疗时CD4细胞计数低、未披露艾滋病毒感染状况和缺乏良好依从性会导致对HAART的免疫反应低下。