Earlier therapy access improves outcomes in children with perinatally acquired HIV infection
MONDAY, May 2 (HealthDay News) -- Most children with perinatal HIV infection are achieving virologic suppression and have normal CD4 lymphocyte counts, according to a study published online March 9 in the Journal of Acquired Immune Deficiency Syndromes.
Russell B. Van Dyke, M.D., from the Tulane University Health Sciences Center in New Orleans, and colleagues investigated the HIV disease status and immune function of children with perinatal HIV infection in the Pediatric HIV/AIDS Cohort study, and examined predictors of their current CD4 count and HIV viral load (VL). Between 2007 and 2009, 451 children (ages 7 to 16 years at entry) were registered as part of four birth cohorts (1991 to 1993, 1994 to 1995, 1996 to 1997, 1998 to 2002), corresponding to changes in the availability and use of antiretroviral drugs.
The investigators found that, at entry, the median CD4 percentage was 33 percent, with 78 percent of children having a CD4 percentage of 25 percent or more and 68 percent having a suppressed VL. A significantly higher CD4 percentage over time was seen in the three more recent birth cohorts compared to the earliest birth cohort. Suppressed entry VL, a higher nadir CD4 percentage, and starting antiretroviral therapy (ART) at a younger age were significant independent predictors of higher CD4 percentage at entry. Independent predictors of suppressed entry VL were membership in a recent birth cohort, male gender, highly-active combination ART use at entry, and fewer prior ART regimens.
"Most children with perinatal HIV maintain virologic suppression and good CD4 values. Earlier treatment results in better immune outcome," the authors write.
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