Publication: Long-term outcomes of HIV-infected children in Thailand: The Thailand pediatric HIV observational database
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Issued Date
2014-01-01
Resource Type
ISSN
18783511
12019712
12019712
Other identifier(s)
2-s2.0-84896535784
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Mahidol University
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SCOPUS
Bibliographic Citation
International Journal of Infectious Diseases. Vol.22, (2014)
Suggested Citation
Wanatpreeya Phongsamart, Rawiwan Hansudewechakul, Torsak Bunupuradah, Virat Klinbuayaem, Sirinya Teeraananchai, Wisit Prasithsirikul, Stephen J. Kerr, Noppadon Akarathum, Sukanda Denjunta, Jintanat Ananworanich, Kulkanya Chokephaibulkit Long-term outcomes of HIV-infected children in Thailand: The Thailand pediatric HIV observational database. International Journal of Infectious Diseases. Vol.22, (2014). doi:10.1016/j.ijid.2013.12.011 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/34822
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Title
Long-term outcomes of HIV-infected children in Thailand: The Thailand pediatric HIV observational database
Abstract
Objective: To describe the outcomes of antiretroviral therapy (ART) in a large cohort of HIV-infected children in Thailand. Methods: The data were obtained from four collaborative referral sites around the country. Data from 2008 to March 2011 were collected prospectively, and data before 2008 were collected retrospectively. Results: Of the 1139 children, 599 (52.6%) were female, and the duration of ART was a median 2.9 years (interquartile range (IQR) 3.3-5.5 years). At ART initiation, the median age was 7.1 years (IQR 3.4-10.0 years), CD4 percentage was 9.0% (IQR 3.0-17.0%), and 61.3% were in World Health Organization (WHO) stage 3 or 4. Seventy-four percent were initiated on an NNRTI-based regimen. The death and lost to follow-up rates were 1.3 (95% confidence interval (CI) 1.1-1.6) and 2.2 (95% CI 1.6-2.6)/100 patient-years of follow-up, respectively. At the last clinic visit of 919 children, the median CD4 percentage was 27.0% (IQR 23.0-32.0%) and 80.2% had HIV-RNA <40 copies/ml. WHO stage 1 or 2 at ART initiation was associated with having a viral load <40 copies/ml (p < 0.002), and baseline CD4 ≥15% and starting with a three-drug regimen were associated with achieving CD4 ≥25% (p<. 0.001). Conclusions: Although most children initiated ART at low CD4 levels, the majority achieved immune reconstitution and long-term virological control. Earlier treatment may improve these outcomes. © 2014 The Authors.