التفاصيل البيبلوغرافية
| العنوان: |
Unsatisfactory long-term virological suppression in human immunodeficiency virus-infected children in the Amazonas State, Brazil |
| المؤلفون: |
Pacheco, Ana Luisa Opromolla, Sabidó, Meritxell, Monteiro, Wuelton Marcelo, Andrade, Solange Dourado de |
| المصدر: |
Revista da Sociedade Brasileira de Medicina Tropical. January 2020 53 |
| بيانات النشر: |
Sociedade Brasileira de Medicina Tropical - SBMT, 2020. |
| سنة النشر: |
2020 |
| مصطلحات موضوعية: |
Highly active antiretroviral therapy, Child, Adolescent, HIV, Sustained virologic response |
| الوصف: |
INTRODUCTION: Achieving viral suppression (VS) in children is challenging despite the exponential increase in access to antiretroviral therapy (ART). We evaluated VS in children >1 year of age and adolescents 5 years after they had begun ART, in Manaus, Amazonas state, Brazil. METHODS: HIV-infected, ART-naive children >1 year of age between 1999 and 2016 were eligible. Analysis was stratified by age at ART initiation: 1-5 y, >5-10 y, and >10-19 y. CD4+ T-cell count and viral load were assessed on arrival at the clinic, on ART initiation, and at 6 months, 1 year, 2 years, and 5 years after ART initiation. The primary outcome was a viral load <50 copies/mL 5 years after ART initiation. RESULTS: Ultimately, 121 patients were included. The mean age at diagnosis was 4.8 years (SD 3.5), mean CD4% was 17.9 (SD 9.8), and mean viral load was 4.6 log10 copies/ml (SD 0.8). Five years after ART initiation, the overall VS rate was 46.9%. VS by patient age group was as follows: 36.6% for 1-5 y, 53.3% for >5-10 y, and 30% for >10-19 y. Almost all children (90,4%) showed an increase in CD4%+ T cell count. There were no statistically significant predictors for detecting children who do not achieve VS with treatment. VS remained below 65% in all the evaluated periods. CONCLUSIONS: Considerable immunological improvement is seen in children after ART initiation. Further efforts are needed to maintain adequate long-term VS levels and improve the survival of this vulnerable population. |
| نوع الوثيقة: |
article |
| وصف الملف: |
text/html |
| اللغة: |
English |
| تدمد: |
0037-8682 |
| DOI: |
10.1590/0037-8682-0333-2020 |
| URL الوصول: |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100364 |
| Rights: |
info:eu-repo/semantics/openAccess |
| رقم الانضمام: |
edssci.S0037.86822020000100364 |
| قاعدة البيانات: |
SciELO |
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