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Acta Paediatr. 2009 Nov;98(11):1787-92. doi: 10.1111/j.1651-2227.2009.01440.x. Epub 2009 Aug 4.

Bridging the gap between adult and paediatric outcomes in HIV-1 vertically infected children: a single-centre comparison with adult data.

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1
Service de Pédiatrie, Hôpital de l'Archet II, Centre Hospitalier Universitaire de Nice, Nice Cedex, France. monpoux.f@chu-nice.fr

Abstract

Prognosis of HIV-1 infection dramatically improved during the last decade. Meanwhile, treatment-induced virological success has always been different in adult and children patients.

AIM:

To compare 10 years of follow up in HIV-1 vertically infected children and adult patients.

METHODS:

Monocentric retrospective longitudinal analysis of vertically HIV-1-infected children and adult patients followed in the Nice University Hospital between 1999 and 2008. Immunological, virological and antiretroviral treatment data were recorded.

RESULTS:

Forty children and 1752 adult patients were included. Between 1996 and 2008, the percentage of children receiving HAART increased from 3.2% to 91%. Mean CD4% in the paediatric group remained stable between 29 +/- 8.1% in 1998 and 30 +/- 9.4% in 2008. Mean adult CD4-cell count significantly increased from 410 in 1998 to 556 cells/mL in 2008. Logistic regression analysis showed that the children-to-adult difference for indetectability (HIV PCR-RNA below 400 copies/mL) was significant (p < 0.0001) with an odds ratio of 0.61 (CI(95th): 0.52-0.72). Year-to-patient interaction was also significant with a decreasing divergence over time (p: 0.038).

CONCLUSION:

Nowadays as in adult patients, the control of HIV-1 replication is achieved in nearly eight of 10 children and the percentage of patients with severe immunodeficiency dramatically decreased compared with the mid 1990s.

PMID:
19681795
PMCID:
PMC2773535
DOI:
10.1111/j.1651-2227.2009.01440.x
[Indexed for MEDLINE]
Free PMC Article
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