| dc.contributor |
Médecins Sans Frontières, Phnom Penh, Cambodia. b.janssens@bigfoot.com |
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| dc.creator |
Janssens, B |
|
| dc.creator |
Raleigh, B |
|
| dc.creator |
Soeung, S |
|
| dc.creator |
Akao, K |
|
| dc.creator |
Te, V |
|
| dc.creator |
Gupta, J |
|
| dc.creator |
Vun, M |
|
| dc.creator |
Ford, N |
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| dc.creator |
Nouhin, J |
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| dc.creator |
Nerrienet, E |
|
| dc.date |
2007-11 |
|
| dc.date.accessioned |
2017-01-31T07:09:58Z |
|
| dc.date.available |
2017-01-31T07:09:58Z |
|
| dc.identifier |
Effectiveness of highly active antiretroviral therapy in HIV-positive children: evaluation at 12 months in a routine program in Cambodia. 2007, 120 (5):e1134-40 Pediatrics |
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| dc.identifier |
1098-4275 |
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| dc.identifier |
17954553 |
|
| dc.identifier |
10.1542/peds.2006-3503 |
|
| dc.identifier |
http://hdl.handle.net/10144/18312 |
|
| dc.identifier |
http://fieldresearch.msf.org/msf/handle/10144/18312 |
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| dc.identifier |
Pediatrics |
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| dc.identifier.uri |
http://dspace.mediu.edu.my:8181/xmlui/handle/10144/18312 |
|
| dc.description |
OBJECTIVE: Increasing access to highly active antiretroviral therapy to reach all those in need in developing countries (scale up) is slowly expanding to HIV-positive children, but documented experience remains limited. We aimed to describe the clinical, immunologic, and virologic outcomes of pediatric patients with >12 months of highly active antiretroviral therapy in 2 routine programs in Cambodia. METHODS: Between June 2003 and March 2005, 212 children who were younger than 13 years started highly active antiretroviral therapy. Most patients started a standard first-line regimen of lamivudine, stavudine, and nevirapine, using split adult fixed-dosage combinations. CD4 percentage and body weight were monitored routinely. A cross-sectional virologic analysis was conducted in January 2006; genotype resistance testing was performed for patients with a detectable viral load. RESULTS: Mean age of the subjects was 6 years. Median CD4 percentage at baseline was 6. Survival was 92% at 12 months and 91% at 24 months; 13 patients died, and 4 were lost to follow-up. A total of 81% of all patients had an undetectable viral load. Among the patients with a detectable viral load, most mutations were associated with resistance to lamivudine and non-nucleoside reverse-transcriptase inhibitor drugs. Five patients had developed extensive antiretroviral resistance. Being an orphan was found to be a predictor of virologic failure. CONCLUSIONS: This study provides additional evidence of the effectiveness of integrating HIV/AIDS care with highly active antiretroviral therapy for children in a routine setting, with good virologic suppression and immunologic recovery achieved by using split adult fixed-dosage combinations. Viral load monitoring and HIV genotyping are valuable tools for the clinical follow-up of the patients. Orphans should receive careful follow-up and extra support. |
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| dc.language |
en |
|
| dc.rights |
Reproduced on this site with kind permission from Pediatrics, Copyright 2007 by the American Academy of Pediatrics |
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| dc.title |
Effectiveness of highly active antiretroviral therapy in HIV-positive children: evaluation at 12 months in a routine program in Cambodia. |
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