Essos Hospital Centre, National Insurance Fund, Yaoundé, Cameroon.
Higher Institute of Medical Technology Nkolondom, Department of Clinical Sciences, University of Douala, Cameroon.
PLoS One. 2019 Mar 18;14(3):e0213900. doi: 10.1371/journal.pone.0213900. eCollection 2019.
There are limited data on protease inhibitor (PI)-based antiretroviral therapy (ART) amongst children in resource-limited settings, for informing on optimal paediatric regimens.
To evaluate therapeutic response to PI-based ART amongst HIV-infected Cameroonian children.
A retrospective study was conducted amongst children aged 2-18 years receiving a PI-based ART at the Essos Hospital Centre (EHC), Yaounde, Cameroon. Primary end points were therapeutic success on PI-based ART, defined as clinical success (WHO I/II clinical stage), immunological success (CD4 ≥ 500/mm3) and viral suppression (viral load [VL]<1000 copies/ml). Factors associated with therapeutic success were assessed in uni- and multivariate analysis using SPSS software v.2.0; with p<0.05 considered statistically significant.
A total of 71 eligible children on PI-based ART were enrolled (42 on initial and 29 on substituted regimens), with a median age of 8 [IQR: 5-12] years and mean duration on ART of 7 years. Following therapeutic responses, all (100%) experienced clinical success, 95.2% experienced immunological success (91.7% on initial and 97.2% on substituted PI/r-based regimens) and 74.7% viral suppression. In univariate analysis, viral suppression was associated with: younger age (p<0.0001), living with parents as opposed to guardians (p = 0.049), and the educational level (p<0.0001). In multivariate analysis, only the age ranges of 10-14 years (OR: 0.22 [0.07-0.73]) and 15-18 years (OR: 0.08 [0.02-0.57]), were determinants of poor viral suppression.
Among these Cameroonian children, PI-based ART confers favourable clinical and immunological outcomes. The poor rate of viral suppression was mainly attributed to adolescence (10-18 years).
在资源有限的环境中，针对儿童的蛋白酶抑制剂（PI）为基础的抗逆转录病毒治疗（ART）的数据有限，无法为最佳儿科方案提供信息。
评估在喀麦隆接受 PI 为基础的 ART 的 HIV 感染儿童的治疗反应。
对喀麦隆雅温得埃索斯医院中心（EHC）接受 PI 为基础的 ART 的 2-18 岁儿童进行了一项回顾性研究。主要终点是 PI 为基础的 ART 的治疗成功，定义为临床成功（WHO I/II 临床分期）、免疫成功（CD4≥500/mm3）和病毒抑制（病毒载量[VL]＜1000 拷贝/ml）。使用 SPSS 软件 v.2.0 进行单变量和多变量分析，评估与治疗成功相关的因素；p＜0.05 被认为具有统计学意义。
共有 71 名符合 PI 为基础的 ART 条件的儿童（42 名接受初始治疗，29 名接受替代治疗），中位年龄为 8 岁[IQR：5-12]，ART 治疗时间平均为 7 年。在治疗反应后，所有儿童（100%）均经历了临床成功，95.2%经历了免疫成功（初始治疗为 91.7%，替代 PI/r 治疗为 97.2%），74.7%实现了病毒抑制。单变量分析显示，病毒抑制与：年龄较小（p＜0.0001）、与父母而不是监护人一起生活（p=0.049）和教育程度（p＜0.0001）相关。多变量分析显示，仅 10-14 岁（OR：0.22[0.07-0.73]）和 15-18 岁（OR：0.08[0.02-0.57]）的年龄范围是病毒抑制不良的决定因素。
在这些喀麦隆儿童中，PI 为基础的 ART 提供了良好的临床和免疫结果。病毒抑制率低主要归因于青春期（10-18 岁）。
