Immunovirological response to combined antiretroviral therapy and drug resistance patterns in children: 1- and 2-year outcomes in rural Uganda
2011

Immunovirological Response to Antiretroviral Therapy in Children in Uganda

Sample size: 102 publication Evidence: moderate

Author Information

Author(s): Ahoua Laurence, Guenther Gunar, Rouzioux Christine, Pinoges Loretxu, Anguzu Paul, Taburet Anne-Marie, Balkan Suna, Olson David M, Olaro Charles, Pujades-Rodríguez Mar

Primary Institution: Clinical Research Department, Epicentre, Paris, France

Hypothesis

What are the treatment outcomes in children treated with antiretroviral therapy in rural Uganda after 1 and 2 years?

Conclusion

After one year of therapy, satisfactory survival and immunological responses were observed, but nearly 1 in 4 children developed viral resistance and/or subtherapeutic plasma antiretroviral drug levels.

Supporting Evidence

  • At M12, 59% of children achieved viral suppression.
  • At M24, 33% of children achieved viral suppression.
  • 25% of children had antiretroviral resistance at M12.
  • 62% of children had antiretroviral resistance at M24.
  • Median CD4 gains were 11% in children < 5 years old at M12.
  • Median CD4 count gain was 206 cells/mm3 in children ≥ 5 years old at M12.
  • 29% of patients had subtherapeutic NNRTI plasma concentrations.

Takeaway

This study looked at how well children in Uganda responded to HIV treatment over one and two years. While many did well, some had problems with the medicine not working as it should.

Methodology

Cross-sectional assessment of children treated with ART for 12 and 24 months, measuring CD4 counts, HIV RNA levels, and drug resistance patterns.

Potential Biases

Potential bias due to reliance on caregiver reports for adherence.

Limitations

The small sample size limited the ability to investigate risk factors for virological failure.

Participant Demographics

Median age was 5 years, with 45% female participants.

Statistical Information

Confidence Interval

95% CI: 0.85-0.95

Digital Object Identifier (DOI)

10.1186/1471-2431-11-67

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