Publication:
HIV-infected children in the Asia-Pacific region with baseline severe anemia: Antiretroviral therapy and outcomes

Issued Date

2016-06-01

Resource Type

Article

ISSN

1875855X
19057415

DOI

10.5372/1905-7415.1003.484

Other identifier(s)

2-s2.0-84986222154

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Asian Biomedicine. Vol.10, No.3 (2016), 229-234

Suggested Citation

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 HIV-infected children in the Asia-Pacific region with baseline severe anemia: Antiretroviral therapy and outcomes. Asian Biomedicine. Vol.10, No.3 (2016), 229-234. doi:10.5372/1905-7415.1003.484 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/43018

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Title

HIV-infected children in the Asia-Pacific region with baseline severe anemia: Antiretroviral therapy and outcomes

Author(s)

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

Other Contributor(s)

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

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.

Keyword(s)

Biochemistry, Genetics and Molecular Biology

Availability

URI

https://repository.li.mahidol.ac.th/handle/123456789/43018

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Scopus 2016-2017