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Germs. 2013 Sep 1;3(3):90-5. doi: 10.11599/germs.2013.1042. eCollection 2013 Sep 1.

Nine-year follow-up of HIV-infected Romanian children and adolescents receiving lopinavir/ritonavir-containing highly active antiretroviral therapy.

Author information

1
MB, ChB, PhD, Baylor College of Medicine International Pediatric AIDS Initiative, Texas Children's Hospital, Houston, Texas, USA.
2
MD, PhD, Ovidius University of Constanţa; Clinical Hospital of Infectious Diseases, Constanţa, Romania.
3
MD, PhD, Carol Davila University of Medicine and Pharmacy, Bucharest; Ştefan S. Nicolau Institute of Virology, Bucharest, Romania.
4
MD, Clinical Hospital of Infectious Diseases, Constanţa, Romania.
5
MD, Baylor College of Medicine, Houston, Texas, USA.
6
RN, MSN, MPH, Baylor College of Medicine International Pediatric AIDS Initiative, Houston, Texas, USA.
7
MA, Baylor-Black Sea Foundation, Constanţa, Romania.
8
MS Baylor College of Medicine International Pediatric AIDS Initiative, Texas Children's Hospital, Houston, Texas, USA.
9
MD Baylor College of Medicine International Pediatric AIDS Initiative, Texas Children's Hospital, Houston, Texas, USA.

Abstract

INTRODUCTION:

Many Romanian children were infected nosocomially with human immunodeficiency virus (HIV) in the late 1980s. The Romanian-American Children's Center of Excellence in Constanţa continues to follow approximately 450 of these patients. In 2001, 414 of these patients were initiated on triple therapy including lopinavir/ritonavir. Data from this cohort treated through August 2006 were published in April 2007 demonstrating that the treatment was well tolerated, with 337 children (81%) remaining on therapy after a median duration of >4 years. The current article describes the results of continued analysis of this cohort through end 2010. The objective of the study was to determine the long-term clinical outcomes of children and adolescents commenced on antiretroviral therapy (ART) including lopinavir/ritonavir.

METHODS:

Data were extracted retrospectively from the charts of the 336 patients remaining on lopinavir/ritonavir in August 2006. The following outcomes were analyzed: mortality, current patient status, viral load (VL), CD4 counts and reasons for discontinuation of lopinavir/ritonavir.

RESULTS:

The median age at initiation of lopinavir/ritonavir was 14.0 years (range 5.4 to 20.0 years). The median time on lopinavir/ritonavir treatment was 7.5 years (interquartile range 5.7 to 8.6 years). Overall mortality was 13.5%. Of the original 414 patients started on lopinavir/ritonavir in 2001, 199 (48.1%) remained on this therapy at the end of 2010 and of these 63.8% had undetectable viral load.

CONCLUSION:

Despite initial suboptimal ART, a significant proportion of patients subsequently treated with a lopinavir/ritonavir based regimen remained on this therapy for up to nine years.

KEYWORDS:

HIV/AIDS; antiretroviral therapy; lopinavir/ritonavir

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