Long-term response to combination antiretroviral therapy in HIV-infected children in the Netherlands registered from 1996 to 2012

Sophie Cohen, Colette Smit, Annemarie M. C. van Rossum, Pieter L. A. Fraaij, Tom F. W. Wolfs, Sibyl P. M. Geelen, Elisabeth H. Schölvinck, Adilia Warris, Henriette J. Scherpbier, Dasja Pajkrt, Dutch Paediatric HIV Study Group

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: To describe demographic and treatment characteristics of the Dutch vertically HIV-infected paediatric population from 1996 to 2012, and to investigate the long-term virological and immunological response to combination antiretroviral therapy (cART), with emphasis on the influence of age at cART initiation and initial CD4 cell counts.

DESIGN: Descriptive cohort study.

METHODS: From 1996 to 2012, all paediatric HIV clinics in the Netherlands provided data on their HIV-infected population. Descriptive statistics, parametric and non-parametric comparative tests, and random-effects linear regression models were performed to investigate the different aspects of this cohort.

RESULTS: A total of 229 vertically HIV-infected children were included. The majority of all mothers (64%) and almost half of the children (43%) originated from sub-Saharan Africa. Ritonavir-boosted lopinavir and efavirenz have replaced indinavir, nelfinavir and nevirapine as preferred first-line cART regimens. Long-term CD4 T-cell reconstitution (with CD4 cell counts corrected for age) was independent of age and CD4 cell count at cART initiation. The decline in HIV viral load after cART introduction occurred faster over the studied time period. The percentage of children with an undetectable viral load rose substantially from 1996 to 2012. Mortality was 0.3 per 100 person-years.

CONCLUSION: A sustained immunological response in the Dutch paediatric HIV-infected population was independent of age as well as CD4 cell count at cART initiation, despite a higher initial HIV viral load in the youngest children. The percentage of children with an undetectable HIV viral load rose substantially over the years and there was a low mortality rate in comparison with reports from other industrialized countries.

Original languageEnglish
Pages (from-to)2567-2575
Number of pages9
JournalAIDS
Volume27
Issue number16
DOIs
Publication statusPublished - 23 Oct 2013

Fingerprint

Netherlands
HIV
CD4 Lymphocyte Count
Viral Load
efavirenz
Therapeutics
Pediatrics
Linear Models
Nelfinavir
Lopinavir
Population
Indinavir
Nevirapine
Ritonavir
Mortality
Africa South of the Sahara
Nonparametric Statistics
Developed Countries
Cohort Studies
Mothers

Keywords

  • antiretroviral therapy
  • children
  • HIV
  • immunological reconstitution
  • mortality
  • the Netherlands
  • vertical transmission
  • virological response
  • Journal Article

Cite this

Cohen, S., Smit, C., van Rossum, A. M. C., Fraaij, P. L. A., Wolfs, T. F. W., Geelen, S. P. M., ... Dutch Paediatric HIV Study Group (2013). Long-term response to combination antiretroviral therapy in HIV-infected children in the Netherlands registered from 1996 to 2012. AIDS, 27(16), 2567-2575. https://doi.org/10.1097/01.aids.0000432451.75980.1b

Long-term response to combination antiretroviral therapy in HIV-infected children in the Netherlands registered from 1996 to 2012. / Cohen, Sophie; Smit, Colette; van Rossum, Annemarie M. C.; Fraaij, Pieter L. A.; Wolfs, Tom F. W.; Geelen, Sibyl P. M.; Schölvinck, Elisabeth H.; Warris, Adilia; Scherpbier, Henriette J.; Pajkrt, Dasja; Dutch Paediatric HIV Study Group.

In: AIDS, Vol. 27, No. 16, 23.10.2013, p. 2567-2575.

Research output: Contribution to journalArticle

Cohen, S, Smit, C, van Rossum, AMC, Fraaij, PLA, Wolfs, TFW, Geelen, SPM, Schölvinck, EH, Warris, A, Scherpbier, HJ, Pajkrt, D & Dutch Paediatric HIV Study Group 2013, 'Long-term response to combination antiretroviral therapy in HIV-infected children in the Netherlands registered from 1996 to 2012', AIDS, vol. 27, no. 16, pp. 2567-2575. https://doi.org/10.1097/01.aids.0000432451.75980.1b
Cohen, Sophie ; Smit, Colette ; van Rossum, Annemarie M. C. ; Fraaij, Pieter L. A. ; Wolfs, Tom F. W. ; Geelen, Sibyl P. M. ; Schölvinck, Elisabeth H. ; Warris, Adilia ; Scherpbier, Henriette J. ; Pajkrt, Dasja ; Dutch Paediatric HIV Study Group. / Long-term response to combination antiretroviral therapy in HIV-infected children in the Netherlands registered from 1996 to 2012. In: AIDS. 2013 ; Vol. 27, No. 16. pp. 2567-2575.
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T1 - Long-term response to combination antiretroviral therapy in HIV-infected children in the Netherlands registered from 1996 to 2012

AU - Cohen, Sophie

AU - Smit, Colette

AU - van Rossum, Annemarie M. C.

AU - Fraaij, Pieter L. A.

AU - Wolfs, Tom F. W.

AU - Geelen, Sibyl P. M.

AU - Schölvinck, Elisabeth H.

AU - Warris, Adilia

AU - Scherpbier, Henriette J.

AU - Pajkrt, Dasja

AU - Dutch Paediatric HIV Study Group

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N2 - OBJECTIVES: To describe demographic and treatment characteristics of the Dutch vertically HIV-infected paediatric population from 1996 to 2012, and to investigate the long-term virological and immunological response to combination antiretroviral therapy (cART), with emphasis on the influence of age at cART initiation and initial CD4 cell counts.DESIGN: Descriptive cohort study.METHODS: From 1996 to 2012, all paediatric HIV clinics in the Netherlands provided data on their HIV-infected population. Descriptive statistics, parametric and non-parametric comparative tests, and random-effects linear regression models were performed to investigate the different aspects of this cohort.RESULTS: A total of 229 vertically HIV-infected children were included. The majority of all mothers (64%) and almost half of the children (43%) originated from sub-Saharan Africa. Ritonavir-boosted lopinavir and efavirenz have replaced indinavir, nelfinavir and nevirapine as preferred first-line cART regimens. Long-term CD4 T-cell reconstitution (with CD4 cell counts corrected for age) was independent of age and CD4 cell count at cART initiation. The decline in HIV viral load after cART introduction occurred faster over the studied time period. The percentage of children with an undetectable viral load rose substantially from 1996 to 2012. Mortality was 0.3 per 100 person-years.CONCLUSION: A sustained immunological response in the Dutch paediatric HIV-infected population was independent of age as well as CD4 cell count at cART initiation, despite a higher initial HIV viral load in the youngest children. The percentage of children with an undetectable HIV viral load rose substantially over the years and there was a low mortality rate in comparison with reports from other industrialized countries.

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KW - antiretroviral therapy

KW - children

KW - HIV

KW - immunological reconstitution

KW - mortality

KW - the Netherlands

KW - vertical transmission

KW - virological response

KW - Journal Article

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DO - 10.1097/01.aids.0000432451.75980.1b

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