Evaluation of therapeutic effects of antiretroviral therapy on pediatric acquired immune deficiency syndrome / 中华传染病杂志

ABSTRACT

Objective To evaluate the therapeutic effects of antiretroviral therapy(ART)on human immunedeficiency virus (HIV)-1-infected children. Methods Twenty-two HIV-1-infected children who met World Health Organization (WHO) criteria for treatment received ART and were prospectively enrolled in this study. ART contained two kinds of nucleoside reverse transcriptase inhibitor (NRTI) combined with one kind of non-nucleoside reverse transcriptase inhibitor (NNRTI).Before ART and 1-36 months after ART, height, body weight, blood routine, peripheral CD4+ and CD8+ T cell counts and plasma viral load were followed up regularly. Comparison between groups was done by test. Results Among the 22 pediatric AIDS patients, 19 cases (86.4%) achieved clinical improve, whose height and body weight increased significantly 6 months after ART (height = 11.04±0. 02, t=2. 356, P<0. 05; body weight= 1 1. 14±0. 01,t=2. 567,P< 0. 05) and opportunistic infection rate decreased (72.7 % vs. 27.3 %) ; 3 patients (13.6 % ) deteriorated, whose height and body weight increased slowly and even decreased, 2 of them died. In the 19 improved patients, viral load declined to <2.7 lg copy/mL at month 3 of ART, CD4+ T cell counts and CD4+/CD8+ ratio significantly increased at month 3 of ART (CD4+ T cell counts 145.50±86.72 vs. 262.80±213.62,t=2. 668, P<0.05; CD4+/CD8+ ratio 0. 14±0. 11 vs. 0.23±0. 21,t=2. 607, P<0. 05) and CD4+/CD8+ ratio peaked at month 9 and absolute number of CD4+ T cell counts peaked at month 12 and maintained at high level until month 36, peripheral white blood cells (WBC) and red blood cells (RBC) both decreased, while hemoglobin (Hb) contents increased significantly (107.29 ± 13.74 vs. 112. 15±11.20,t=2. 325,P<0. 05). Conclusion ART is an effective strategy for inhibition of HIV-1 replication,reconstruction of immune responses and improvement of clinical symptoms in AIDS children.