Highly active antiretroviral therapies among HIV-1-infected children in Abidjan, C??te d'Ivoire

Institut de Recherche en Cancerologie de Montpellier, Montpelhièr, Languedoc-Roussillon, France
AIDS (Impact Factor: 5.55). 09/2004; 18(14):1905-13. DOI: 10.1097/00002030-200409240-00006
Source: PubMed


To describe the effect of highly active antiretroviral therapy (HAART) in HIV-1-infected African children.
Observational ANRS 1244 cohort of 159 children with HIV between October 2000 and September 2002; 78 children (49%) receiving HAART were followed for a mean duration of 21 months.
Weight-for-age Z-scores (WAZ), height-for-age Z-scores (HAZ), CD4 lymphocyte count and HIV-1 RNA viral load were measured before initiating HAART and every 6 months during treatment. Probability of survival and incidences of pneumonia and acute diarrhoea were calculated.
Values before and after 620 days of HAART, respectively, were -2.02 and -1.39 for mean WAZ, (P < 0.01); -2.03 and -1.83 for mean HAZ (P = 0.51); 0.07 and 0.025/child-month (P = 0.002) for incidence of pneumonia; and 0.12 and 0.048/child-month for incidence of acute diarrhoea (P < 0.001) (incidence changes statistically significant only in children < 6.5 years). Overall, the probability of survival under HAART was 72.8% at 24 months for children with < 5% CD4 cells versus 97.8% in children with >/= 5% (P < 0.01). At HAART initiation, median viral load and CD4 cell percentage were 5.41 log10 copies/ml and 7.7%, respectively. After 756 days of HAART, on average, 50% of patients had undetectable viral load and 10% had 2.4-3.0 log10 copies/ml. The median CD4 percentage was 22.5%.
In resource-limited setting, it is possible to use HAART to treat African children. This treatment appears as effective as in developed countries.

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Available from: Philippe Msellati
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    • "Both absolute CD4 cell counts and CD4 cell percentages demonstrated a sustained immunologic response through 24 months of follow-up for all participants. Our findings are consistent with reports of effectiveness of ART in HIV-infected children from other countries in sub-Saharan Africa [2-5]. "
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    • "Single-centre studies from West Africa have documented anaemia in children on ART. However, to date there are no multi-centre data from this region [6, 7]. The paediatric West African Database on AIDS (pWADA) undertook this study to determine the risk of severe anaemia and its predictors after the initiation of ZDV-containing ART or non-ZDV- (Stavudine or Abacavir) containing ART in HIV-infected children. "
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