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HIV-1 感染儿童的高效抗逆转录病毒治疗的免疫和病毒学反应。

Immunological and Virological Responses to Highly Active Antiretroviral Therapy in HIV-1 Infected Children.

机构信息

Department of Pediatrics, All India Institute of Medical Sciences, Room no. 3061A, New Delhi, 110029, India.

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian J Pediatr. 2017 Dec;84(12):893-896. doi: 10.1007/s12098-017-2441-y. Epub 2017 Sep 6.

Abstract

OBJECTIVE

To evaluate immunological and virological outcomes in human immunodeficiency virus (HIV) infected children at six months of highly active antiretroviral therapy (HAART).

METHODS

Records of HIV infected children <15-y-old were reviewed to identify those who were initiated highly active antiretroviral therapy between 2010 and 2014 and had CD4+ T cell percentage and HIV-1 viral load report at baseline visit and after 6 mo of initiation of the treatment.

RESULTS

Seventy-four HIV infected children [26% girls, median age IQR 36 (24-108) mo] were included in the study. At the end of six months of HAART, median increase of 11% (6-15%) in CD4+ T cell percentage from the baseline levels was observed; nineteen (26%) children showed an increase in CD4+ T cell percentage of 15% or more at 6 mo. Viral load was undetectable (<47 copies/ml) in 27 (36.4%) children; 21 (28.3%) children had 47- < 500 copies/ml; 16 (21.6%) children had 500- < 10,000 copies/ml and 10 (13.5%) children had ≥10,000 copies/ml. At six months, only 15 (20.2%) children exhibited positive immuno-virological response to HAART (≥ 15% increase in CD4% and <47 HIV-1 RNA copies/ml).

CONCLUSIONS

While HAART was effective in improving the immunological and virological parameters in the index cohort of children, virological responses were less robust.

摘要

目的

评估人类免疫缺陷病毒(HIV)感染儿童在开始高效抗逆转录病毒治疗(HAART)后 6 个月的免疫和病毒学结果。

方法

回顾性分析了 2010 年至 2014 年期间开始接受高效抗逆转录病毒治疗的<15 岁 HIV 感染儿童的记录,这些儿童在基线访视和治疗开始后 6 个月时具有 CD4+T 细胞百分比和 HIV-1 病毒载量报告。

结果

本研究共纳入 74 例 HIV 感染儿童[26%为女孩,中位年龄 IQR 36(24-108)mo]。在 HAART 治疗 6 个月后,与基线水平相比,CD4+T 细胞百分比中位数增加了 11%(6-15%);19 例(26%)儿童在 6 个月时 CD4+T 细胞百分比增加了 15%或更多。27 例(36.4%)儿童的病毒载量不可检测(<47 拷贝/ml);21 例(28.3%)儿童为 47-<500 拷贝/ml;16 例(21.6%)儿童为 500-<10,000 拷贝/ml,10 例(13.5%)儿童为≥10,000 拷贝/ml。在 6 个月时,只有 15 例(20.2%)儿童对 HAART 表现出阳性免疫病毒学反应(CD4%增加≥15%且<47 HIV-1 RNA 拷贝/ml)。

结论

虽然 HAART 有效地改善了指数队列儿童的免疫和病毒学参数,但病毒学反应不太理想。

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