Journal Article

Virologic Suppression in Nevirapine-Exposed HIV-Infected Infants Initiating Antiretroviral Therapy in Rural Uganda

Jenna Kay, Humphrey Wanzira, Taylor Sandison, Abel Kakuru, Victor Bigira, Moses Kamya, Jaco Homsy, Jordan W. Tappero, Diane Havlir, Grant Dorsey and Theodore Ruel

in Journal of Tropical Pediatrics

Volume 58, issue 3, pages 194-199
Published in print June 2012 | ISSN: 0142-6338
Published online September 2011 | e-ISSN: 1465-3664 | DOI: http://dx.doi.org/10.1093/tropej/fmr071
Virologic Suppression in Nevirapine-Exposed HIV-Infected Infants Initiating Antiretroviral Therapy in Rural Uganda

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We measured virologic suppression among 34 nevirapine (NVP)-exposed HIV-infected children with median age of 8.6 months (range: 3.2–19.9) initiating NVP-based antiretroviral therapy (ART) in rural Uganda. In Kaplan–Meier analysis, the cumulative probability of virologic suppression, defined as having two consecutive HIV-1 RNA <400 copies ml−1 by 18 months was 56%. In multivariate Cox proportional hazard modeling, the following pre-ART measurements were independently associated with an increased probability of viral suppression: increasing age [hazard ratio (HR) =1.28 per 1 month increase in age, p = 0.002], lower viral load (HR = 3.54 for HIV RNA > 7 50 000 copies ml−1, p = 0.03) and high CD4% (HR = 6.0 for CD4% > 25, p = 0.003). These results lend additional support to the 2010 World Health Organization recommendations that protease inhibitors be used to treat NVP-exposed children, but that NVP-based ART should be initiated before the decline of CD4% to optimize outcomes in NVP-exposed children when protease inhibitors are not available.

Keywords: HIV; nevirapine; children; treatment; Africa

Journal Article.  2806 words.  Illustrated.

Subjects: Paediatrics

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