Factors associated with clinical, immunological and virological responses in protease-inhibitor-experienced brazilian children receiving highly active antiretroviral therapy containing Lopinavir-Ritonavir

Factors associated with clinical, immunological and virological responses in protease-inhibitor-experienced brazilian children receiving highly active antiretroviral therapy containing Lopinavir-Ritonavir

Author Machado, Daisy Maria Autor UNIFESP Google Scholar
Gouvêa, Aida de Fátima Thomé Barbosa Autor UNIFESP Google Scholar
Cardoso, Maria Regina Google Scholar
Beltrão, Suênia Vasconcelos Autor UNIFESP Google Scholar
Cunegundes, Kelly Simone Autor UNIFESP Google Scholar
Bononi, Fabiana Autor UNIFESP Google Scholar
Almeida, Fernanda Autor UNIFESP Google Scholar
Cavalheiro, Kaline Autor UNIFESP Google Scholar
Angelis, Daniela Souza Araújo de Google Scholar
Succi, Regina Célia de Menezes Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
São Paulo University Faculty of Public Health
Universidade de São Paulo (USP)
Abstract This study evaluates clinical, virological and immunological responses to antiretroviral (ARV) therapy based on Lopinavir/ritonovir (LPV/r) in previously protease -inhibitor-experienced children. The study included 29 Brazilian children (median age = 5.91 years) who had failed previous ARV therapy and had begun a regimen based on LPV/r. At 12 months follow-up, a good virological response to LPV/r therapy was defined as achieving an undetectable viral load or as a decrease in plasma HIV RNA levels to > 1 log. A good immunological response was defined as an increase in CD4+ cell count from baseline sufficient to attain a better CDC immune stage classification. The number of infectious episodes 12 months before and 12 months after beginning LPV/r was assessed. Sixteen (55.2%) and 19 (65.5%) of 29 patients exhibited good virological and immunological responses, respectively. Baseline CD4+ values (>500) predicted both virological and immunological responses (p<0.05). Older children were less likely to develop an immunological response (p<0.001) than younger children. Nine children receiving 3 ARV drugs plus LPV/r showed an immunological response (100%) compared to 10/20 (50%) children receiving 2 drugs plus LPV/r (p=0.01). A lower number (n<5) of infectious episodes was noted after 12 months follow-up in children using the LPV/r regimen (p=0.006). There was a positive correlation between children whose baseline CD4+ values were greater than 500 cells/mm³ and virological responses. Although virological responses to therapy were seen in about half the children (55.2%), the use of HAART containing LPV/r provided clinical and immmunological benefits.
Keywords HIV
children
HAART
lopinavir
Language English
Date 2007-02-01
Published in Brazilian Journal of Infectious Diseases. Brazilian Society of Infectious Diseases, v. 11, n. 1, p. 16-19, 2007.
ISSN 1413-8670 (Sherpa/Romeo, impact factor)
Publisher Brazilian Society of Infectious Diseases
Extent 16-19
Origin http://dx.doi.org/10.1590/S1413-86702007000100006
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000253997600006
SciELO ID S1413-86702007000100006 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/3523

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