Treatment outcomes among HIV-1 and HIV-2 infected children initiating antiretroviral therapy in a concentrated low prevalence setting in West Africa 英文参考文献.docVIP

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Treatment outcomes among HIV-1 and HIV-2 infected children initiating antiretroviral therapy in a concentrated low prevalence setting in West Africa 英文参考文献.doc

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Treatment outcomes among HIV-1 and HIV-2 infected children initiating antiretroviral therapy in a concentrated low prevalence setting in West Africa 英文参考文献

Okomoetal.BMCPediatrics2012,12:95 /1471-2431/12/95 RESEARCH ARTICLE OpenAccess TreatmentoutcomesamongHIV-1andHIV-2 infectedchildreninitiatingantiretroviraltherapy inaconcentratedlowprevalencesettingin WestAfrica UduakOkomo1*,ToyinTogun1,FrancisOko1,KevinPeterson1,2,JohnTownend1,IngridPeterson3andAssanJaye1,4 Abstract Background:Thereislittledataonresponsestocombinationantiretroviraltherapy(cART)amongHIV-infected childrenintheWestAfricanregion.WedescribetreatmentoutcomesamongHIV-1andHIV-2infectedchildren initiatingcARTinaresearchclinicinTheGambia,WestAfrica. Methods:AlltreatmentnaiveHIV-infectedchildrenwhoinitiatedcARTaccordingtotheWHOARTguidelinesfor childrenbetweenOctober2004andDecember2009wereincludedintheanalysis.Kaplan-Meirestimatesandsign- ranktestwereusedtoinvestigatetheresponsestotreatment. Results:65HIV-1andfiveHIV-2infectedchildrenaged15yearswereinitiatedoncARToverthistimeperiod.HIV-1 infectedchildrenweretreatedwithacombinationofZidovudineorStavudine+Lamivudine+NevirapineorEfavirenz whilechildrenwithHIV-2weretreatedwithZidovudine+Lamivudine+ritonavir-boostedLopinavir.HIV-1infected childrenwerefollowed-upforamedian(IQR)durationof20.1months(6.9–34.3),withtheirmedian(IQR)ageat treatmentinitiation,CD4%andplasmaviralloadatbaselinefoundtobe4.9years(2.1–9.1),13.0%(7.0–16.0)and5.4 log10copies/ml(4.4–6.0)respectively.ThemedianageattreatmentinitiationofthefiveHIV-2infectedchildrenwas 12years(range:4.6–14.0)whiletheirmedianbaselineCD4+TcellcountandHIV-2viralloadwere140cells/mm3 (Range:40–570cells/mm3)and4.5log10copies/mL(Range:3.1-4.9log10copies/mL)respectively. AmongHIV-1infectedchildren5yearsofageatARTinitiation,themedian(IQR)increasesinCD4%frombaselineto 12,24and36monthswere14%(8–19;P=0.0004),21%(15–22;P=0.005)and15%(15–25;P=0.0422)respectively, whilethemedian(IQR)increaseinabsoluteCD4Tcellcountfrombaselineto12,24and36monthsforthose≥ 5years atARTinitiationwere470cells/mm3(270–650;P=0.0005),230cells/mm3(30–610;P=0.0196)and615cells/mm3 (250–1060;P=0.0180)respectiv