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Long-term survival and immuno-virological response of African HIV-1-infected children to highly active antiretroviral therapy regimens

Rouet, Françoisa; Fassinou, Patriciab; Inwoley, Andréa; Anaky, Marie-Francec; Kouakoussui, Alainc; Rouzioux, Christined; Blanche, Stéphanee; Msellati, Philippef; for the ANRS 1244/1278 Programme Enfants Yopougon

doi: 10.1097/QAD.0b013e328010943b
Clinical Science: Concise Communication

Background: In Africa, facing the scaling-up of HAART, there is an urgent need to monitor accurately the long-term benefits of these lifelong treatments.

Methods: Survival and immuno-virological response were assessed for 78 children in the ANRS 1244/1278 Children's cohort (Abidjan, Côte d'Ivoire) who were enrolled from October 2000 for treatment with HAART and followed to September 2004. Initial HAART consisted of two nucleoside reverse transcriptase inhibitors with either nelfinavir (NFV) or efavirenz (EFV). For the comparison of immunological and virological responses, CD4 cell counts and HIV-1 RNA viral load were assessed by performing time-point specific and longitudinal data analysis.

Results: At baseline, the median CD4 cell percentage was 7.5% and the median HIV-1 RNA viral load was 5.37 log10 copies/ml. The survival probability was high (0.86 at month 42; 95% confidence interval, 0.77–0.92) with no difference according to whether the HAART regimen contained NFV or EFV. At 36 and 42 months of follow-up, an immune recovery was observed with median CD4 cell percentages reaching 23.1% and 24.8%, respectively, with no difference according to the HAART regimen (longitudinal data analysis). At the same time points, a sustained viral suppression was also obtained, with undetectable viral load achieving in 46.5% and 45.0%, respectively, regardless of whether the HAART regimen.

Conclusion: This study demonstrates the durability of both clinical and biological response to HAART in African children.

From the aCentre de Diagnostic et de Recherches sur le SIDA (CeDReS), CHU de Treichville

bService de Pédiatrie, CHU Yopougon

cProgramme Enfant Yopougon/PACCI, Abidjan, Côte d'Ivoire

dLaboratoire de Virologie, CHU Necker-Enfants Malades

eService d'Immunologie et d'Hématologie Pédiatrique, CHU Necker-Enfants Malades, Paris

fUMR145, Institut de Recherche et Développement (IRD), Université de Montpellier, France.

Received 2 February, 2006

Revised 28 August, 2006

Accepted 6 September, 2006

Correspondence to Dr F. Rouet, Laboratoire de Virologie, Centre Muraz 01, BP 390 BOBO-DIOULASSO 01, Burkina Faso. E-mail: franrouet@yahoo.fr

© 2006 Lippincott Williams & Wilkins, Inc.