Immunological and Virological Responses to Highly Active Antiretroviral Therapy in HIV-1 Infected Children.

Objective: To evaluate immunological and virological outcomes in human immunodeficiency virus (HIV) infected children at six months of highly active antiretroviral therapy (HAART).

Methods: Records of HIV infected children <15-y-old were reviewed to identify those who were initiated highly active antiretroviral therapy between 2010 and 2014 and had CD4+ T cell percentage and HIV-1 viral load report at baseline visit and after 6 mo of initiation of the treatment.

Results: Seventy-four HIV infected children [26% girls, median age IQR 36 (24-108) mo] were included in the study. At the end of six months of HAART, median increase of 11% (6-15%) in CD4+ T cell percentage from the baseline levels was observed; nineteen (26%) children showed an increase in CD4+ T cell percentage of 15% or more at 6 mo. Viral load was undetectable (<47 copies/ml) in 27 (36.4%) children; 21 (28.3%) children had 47- < 500 copies/ml; 16 (21.6%) children had 500- < 10,000 copies/ml and 10 (13.5%) children had ≥10,000 copies/ml. At six months, only 15 (20.2%) children exhibited positive immuno-virological response to HAART (≥ 15% increase in CD4% and <47 HIV-1 RNA copies/ml).

Conclusions: While HAART was effective in improving the immunological and virological parameters in the index cohort of children, virological responses were less robust.