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Title: HIV-infected children in the Asia-Pacific region with baseline severe anemia: Antiretroviral therapy and outcomes
Authors: Pagakrong Lumbiganon
Pope Kosalaraksa
Torsak Bunupuradah
David Boettiger
Vonthanak Saphonn
Khanh H. Truong
Nia Kurniati
Rawiwan Hansudewechakul
Viet C. Do
Tavitiya Sudjaritruk
Nagalingeswaran Kumarasamy
Nantakar Kongstan
Nik K.N. Yusoff
Lam V. Nguyen
Dewi K. Wati
Kamarul Razali
Annette H. Sohn
Azar Kariminia
Khon Kaen University
The HIV Netherlands Australia Thailand Research Collaboration
University of New South Wales (UNSW) Australia
National Center for HIV/AIDS
Children's Hospital 1
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Chiangrai Prachanukroh Hospital
Children's Hospital 2
Chiang Mai University
VHS Medical Centre India
Mahidol University
Hospital Raja Perempuan Zainab II
National Hospital of Pediatrics Hanoi
Universitas Udayana
Kuala Lumpur Hospital
amfAR - The Foundation for AIDS Research
Keywords: Biochemistry, Genetics and Molecular Biology
Issue Date: 1-Jun-2016
Citation: Asian Biomedicine. Vol.10, No.3 (2016), 229-234
Abstract: Background: Severe anemia is common among children infected with human immunodeficiency virus (HIV). The choice of antiretroviral (ART) regimen needs careful consideration. No information is available regarding the initial ART regimens used in the Asia-Pacific region and the rate of switch of ART regimens in HIV-infected children with severe anemia. Objectives: To study the initial ART regimens and the rate of switch of ART regimens used during the first 36 months in HIV-infected children with severe anemia and to evaluate their clinical and laboratory outcomes. Methods: We analyzed regional cohort data of 130 Asian children aged <18 years with baseline severe anemia (hemoglobin <7.5 g/dl) who started antiretroviral therapy (ART) between January 2003 and September 2013. Results: At ART initiation, median age was 3.5 years old (interquartile range (IQR) 1.7 to 6.3) and median hemoglobin was 6.7 g/dL (IQR 5.9-7.1, range 3.0-7.4). Initial ART regimens included stavudine (85.4%), zidovudine (13.8%), and abacavir (0.8%). In 81 children with available hemoglobin data after 6 months of ART, 90% recovered from severe anemia with a median hemoglobin of 10.7 g/dL (IQR 9.6-11.7, range 4.4-13.5). Those starting AZT-based ART had a mortality rate of 10.8 (95% confidence interval (CI) 4.8-23.9) per 100 patient-years compared to 2.7 (95% CI 1.6-4.6) per 100 patient-years among those who started d4T-based ART. Conclusions: With the phase-out of stavudine, age-appropriate non-zidovudine options are needed for younger Asian children with severe anemia.
ISSN: 1875855X
Appears in Collections:Scopus 2016-2017

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