Chiappini Elena, Larotonda Francesca, Lisi Catiuscia, Giacomet Vania, Erba Paola, Bernardi Stefania, Zangari Paola, Di Biagio Antonio, Taramasso Lucia, Giaquinto Carlo, Rampon Osvalda, Gabiano Clara, Garazzino Silvia, Tagliabue Claudia, Esposito Susanna, Bruzzese Eugenia, Badolato Raffaele, Zanaboni Domenico, Cellini Monica, Dedoni Maurizio, Mazza Antonio, Pession Andrea, Giannini Anna Maria, Salvini Filippo, Dodi Icilio, Carloni Ines, Cazzato Salvatore, Tovo Pier Angelo, de Martino Maurizio, Galli Luisa
Paediatric Infectious Diseases Unit, Department of Health Sciences, Anna Meyer Children's Hospital, University of Florence, Florence, Italy.
Department of Paediatric Medicine, Anna Meyer Children's Hospital, University of Florence, Florence, Italy.
Front Pediatr. 2021 Jul 16;9:665764. doi: 10.3389/fped.2021.665764. eCollection 2021.
Combined antiretroviral therapy (cART) has been associated with a steep decrease in mortality and morbidity in HIV-1 infected children. New antiretroviral molecules and drug classes have been developed and the management of HIV-infected children has improved, but recent data on survival are limited. An observational retrospective study investigating changes in mortality and morbidity was conducted on 1,091 perinatally HIV-1 infected children enrolled in the Italian Register for HIV Infection in Children and followed-up from 2001 to 2018. Three hundred and fifty-four (32%) AIDS events and 26 (2%) deaths occurred overtime. Mortality rates decreased from 0.4/100 person-years in 2001-2006 to 0.27/100 person-years in 2007-2012 and 0.07/100 person-years in 2013-2018. Notably, 92% of the dead children were born in Italy, but only 50% were followed-up since birth or within three months of age. Seventy three percent of children had started cART at age ≥6 months; 23% were treated for <30 days before death. B and C clinical events progressively decreased ( < 0.0001). Opportunistic infections significantly decreased over time, but still were the most common events in all the periods (6.76/100 person-years in 2013-2018). In the last period, severe bacterial infections were the most common ones. Cancer rates were 0.07/100; 0.17/100; 0.07/100 person-years in the three periods, respectively. Progressive reductions both in mortality and in rates of class B and C clinical events and OIs have been observed during the cART era. However, deaths were still registered; more than half of dead children were enrolled after birth and had belatedly started cART.
联合抗逆转录病毒疗法（cART）已使HIV-1感染儿童的死亡率和发病率大幅下降。新的抗逆转录病毒分子和药物类别不断涌现，HIV感染儿童的治疗管理也有所改善，但近期有关生存率的数据有限。对1091名围产期感染HIV-1的儿童进行了一项观察性回顾研究，这些儿童被纳入意大利儿童HIV感染登记系统，并于2001年至2018年接受随访。随时间推移，发生了354起（32%）艾滋病事件和26起（2%）死亡事件。死亡率从2001 - 2006年的0.4/100人年降至2007 - 2012年的0.27/100人年，再降至2013 - 2018年的0.07/100人年。值得注意的是，92%的死亡儿童出生在意大利，但只有50%从出生或出生后三个月内开始接受随访。73%的儿童在6个月及以上开始接受cART治疗；23%在死亡前接受治疗不足30天。B类和C类临床事件逐渐减少（<0.0001）。机会性感染随时间显著减少，但在所有时期仍是最常见的事件（2013 - 2018年为6.76/100人年）。在最后一个时期，严重细菌感染最为常见。三个时期的癌症发病率分别为0.07/100、0.17/100、0.07/100人年。在cART时代，死亡率以及B类和C类临床事件和机会性感染的发生率均逐步下降。然而，仍有死亡病例登记；超过一半的死亡儿童在出生后登记入组，且开始cART治疗较晚。
Epidemiol Prev. 2013
East Afr Med J. 2009-8
Infect Dis Rep. 2024-10-10
Annu Rev Pharmacol Toxicol. 2023-1-20
Clin Microbiol Infect. 2019-11
Handb Exp Pharmacol. 2020
Handb Clin Neurol. 2018
J Acquir Immune Defic Syndr. 2017-8-1
Nat Rev Neurol. 2016-4
Pediatr Infect Dis J. 2016-6
Zotero 插件
