Details

Autor(en) / Beteiligte

• Chappell, Elizabeth
• Riordan, Andrew
• Goodall, Ruth
• Galli, Luisa
• Klimkait, Thomas
• Kiseleva, Galyna
• Le Chenadec, Jerome
• Ait si Selmi, Lamya
• Brossard, Maud
• Floch-Tudal, Corinne
• Firtion, Ghislaine
• Bolot, Pascal
• Blanche, Stéphane
• Schultze-Strasser, Stephan
• Berlin, Charite
• Larovere, Domenico
• Venturini, Elisabetta
• Di Biagio, Antonio
• Lipreri, Rita
• Dodi, Icilio
• Consolini, Rita
• Garazzino, Silvia
• Pellegatta, Antonio
• Pajkrt, D
• Cornelissen, M T E
• Schinkel, C J
• Visser, E G
• Strik-Albers, R
• Bont, L J
• van Houdt, R
• Bezemer, D O
• van Sighem, A I
• Boender, T S
• Zaheri, S
• Bergsma, D
• Meijering, R
• Munjishvili, L
• Timmerman, A
• Woudstra, T
• Coupland, Urszula
• Fernandes, Alexandre
• Tomás Ramos, José
• Gómez Sirvent, Jorge
• Román, Vicente
• Falcón, Lola
• Luis Santos, Juan
• Losada, Begoña
• Guerrero, Carmelo
• Collado, Pilar
• Pérez, Amparo
• Gavilán, César
• Dapena, Marta
• Marugán, Víctor
• Alfayate, Santiago
• Aubert, V
• Battegay, M
• Brazzola, P
• Dollenmaier, G
• Elzi, L
• Haerry, D
• Hoffmann, M
• Keiser, O
• Ledergerber, B
• Martinetti, G
• Nicca, D
• Rauch, A
• Tarr, P
• Wandeler, G
• Wyler, C A
• Ngampiyaskul, Chaiwat
• Kamonpakorn, Nareerat
• Jaisieng, Nirattiya
• Kawilapat, Suttipong
• Prymak, N
• Bailey, H
• Butler, Karina
• Francis, Kate
• Harrison, Ian
• Nsangi, Edith
• Cook, Claire
• Fairbrother, Keith
• Thrasyvoulou, L
• Welch, S
• Sloper, K
• Hague, R
• Cardoso, A
• Shingadia, D
• Gurtin, D
• Bandi, S
• Cliffe, L
• Smyth, A
• Freeman, H
• Gordon, A
• Riordan, A
• Monrose, C
• Menson, E
• Callaghan, A
• Blake, E
• Yannoulias, A
• Gomezpena, Daniel

Titel

Prevalence and Clinical Outcomes of Poor Immune Response Despite Virologically Suppressive Antiretroviral Therapy Among Children and Adolescents With Human Immunodeficiency Virus in Europe and Thailand: Cohort Study

Ist Teil von

• Clinical infectious diseases, 2020-01, Vol.70 (3), p.404-415

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Background In human immunodeficiency virus (HIV)–positive adults, low CD4 cell counts despite fully suppressed HIV-1 RNA on antiretroviral therapy (ART) have been associated with increased risk of morbidity and mortality. We assessed the prevalence and outcomes of poor immune response (PIR) in children receiving suppressive ART. Methods Sixteen cohorts from the European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) contributed data. Children <18 years at ART initiation, with sustained viral suppression (VS) (≤400 copies/mL) for ≥1 year were included. The prevalence of PIR (defined as World Health Organization advanced/severe immunosuppression for age) at 1 year of VS was described. Factors associated with PIR were assessed using logistic regression. Rates of acquired immunodeficiency syndrome (AIDS) or death on suppressive ART were calculated by PIR status. Results Of 2318 children included, median age was 6.4 years and 68% had advanced/severe immunosuppression at ART initiation. At 1 year of VS, 12% had PIR. In multivariable analysis, PIR was associated with older age and worse immunological stage at ART start, hepatitis B coinfection, and residing in Thailand (all P ≤ .03). Rates of AIDS/death (95% confidence interval) per 100 000 person-years were 1052 (547, 2022) among PIR versus 261 (166, 409) among immune responders; rate ratio of 4.04 (1.83, 8.92; P < .001). Conclusions One in eight children in our cohort experienced PIR despite sustained VS. While the overall rate of AIDS/death was low, children with PIR had a 4-fold increase in risk of event as compared with immune responders. One in eight children living with human immunodeficiency virus in Europe and Thailand experienced poor immune response at 1 year of virally suppressive antiretroviral therapy. These children had a 4-fold increased risk of AIDS or death compared with immune responders.