Antiretroviral therapy for HIV-1-infected children in Haiti.

TitleAntiretroviral therapy for HIV-1-infected children in Haiti.
Publication TypeJournal Article
Year of Publication2007
AuthorsGeorge E, Noël F, Bois G, Cassagnol R, Estavien L, Rouzier PDe Matteis, Verdier RI, Johnson WD, Pape JW, Fitzgerald DW, Wright PF
JournalJ Infect Dis
Volume195
Issue10
Pagination1411-8
Date Published2007 May 15
ISSN0022-1899
KeywordsAcquired Immunodeficiency Syndrome, Antiretroviral Therapy, Highly Active, Child, Follow-Up Studies, Haiti, HIV-1, Humans, Poverty, Survival Analysis, Treatment Outcome, Viral Load
Abstract

BACKGROUND: Data are limited about the effectiveness of pediatric antiretroviral therapy (ART) in low-income countries.

METHODS: We report the outcomes of consecutively treating 236 human immunodeficiency virus type 1 (HIV-1)-infected treatment-naive children with triple ART in Port-au-Prince, Haiti, between 1 May 2003 and 30 April 2006.

RESULTS: Kaplan-Meier survival analysis at follow-up demonstrated that 191 children (81%) remained in care, 21 (9%) were dead, and 24 (10%) were lost to follow-up. Independent baseline predictors of mortality were age <18 months, CD4(+) T cell percentage < or =5%, and weight-for-age Z score (WAZ) less than -3. Twelve months into ART, 56% of tested subjects had undetectable HIV-1 RNA loads. Median CD4(+) T cell percentages at 12 months increased by 15%, 11%, and 5% in children with baseline percentages of < or =5%, 6%-24%, and > or =25%, respectively (P<.01). The median WAZ at 12 months increased by 1.0, 0.6, and 0.2 in children with baseline WAZ less than -2, -2 to -1.1, and -1 or more, respectively (P<.01).

CONCLUSION: With continuous donor support, trained providers, and the availability of pediatric antiretroviral drug formulations, it proved feasible to deliver pediatric ART in Haiti. The effectiveness of this program should encourage efforts to make ART available for HIV-infected children in poor countries.

DOI10.1086/514823
Alternate JournalJ. Infect. Dis.
PubMed ID17436220
Grant ListAI07613 / AI / NIAID NIH HHS / United States
AI58257 / AI / NIAID NIH HHS / United States
AI64021 / AI / NIAID NIH HHS / United States
TW00018 / TW / FIC NIH HHS / United States
TW006896 / TW / FIC NIH HHS / United States
TW006901 / TW / FIC NIH HHS / United States