Feasibility and Effectiveness of Early Initiation of Combination Antiretroviral Therapy in HIV-infected Infants in a Government Clinic of Kwazulu-Natal, South Africa

A recent randomized trial showed dramatic improvement in survival of HIV-infected infants receiving early combination antiretroviral therapy (cART). However, few data are available for resource-limited settings. Therefore we conducted a chart review of HIV-infected infants initiated on cART between...

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Bibliographic Details
Published in:Journal of tropical pediatrics (1980) 2012-04, Vol.58 (2), p.114-119
Main Authors: PURCHASE, Susan E, VAN DER LINDEN, Dimitri J, MCKERROW, Neil H
Format: Article
Language:English
Subjects:
Age
Anti-Retroviral Agents - therapeutic use
Antibiotics. Antiinfectious agents. Antiparasitic agents
antiretroviral therapy
Antiviral agents
Biological and medical sciences
CD4 antigen
CD4 Lymphocyte Count
Children
Data processing
Drug Therapy, Combination
Feasibility Studies
Female
Follow-Up Studies
General aspects
HIV
HIV Infections - drug therapy
HIV Infections - immunology
Human immunodeficiency virus
Human viral diseases
Humans
Infant
Infants
Infectious diseases
Male
Medical sciences
Pharmacology. Drug treatments
Retrospective Studies
Reviews
South Africa
Survival
Treatment Outcome
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Viral Load
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Summary:A recent randomized trial showed dramatic improvement in survival of HIV-infected infants receiving early combination antiretroviral therapy (cART). However, few data are available for resource-limited settings. Therefore we conducted a chart review of HIV-infected infants initiated on cART between 2005 and 2008. Of 129 treated infants, 94 completed 6 months, 62 completed 12 months, and 39 completed 18 months of cART. Median age at initiation of cART was 8.6 months (range 2.1-11.9) and 77.2% had advanced disease. Undetectable VL was found in 78.8% of children who reached 18 months of treatment. CD4% increased from a median of 15.4% at baseline to 33.1% at 18 months. Weight for age Z-score increased from a mean ± SD of -2.7 ± 1.97 to 0.02 ± 1.10 at 18 months. Findings show favourable response to cART in HIV-infected infants outside a research environment, despite initial advanced disease. Efforts should be made to initiate cART as early as possible.
ISSN:0142-6338
1465-3664
DOI:10.1093/tropej/fmr053