Clinical characteristics of pediatric HIV-1 patients treated with first-line antiretroviral therapy in Vietnam: a nested case–control study

Dang, Minh; Nguyen, Duc Minh; Tran, Huu Bich; Pham, Viet Hung; Daryl,; L, Pham; Phan, Thi Quynh; Dinh, Thi Thanh; Le, Thi Kim Anh; Nguyen, Van Lam; Le, Thanh Hai; Hoang, Son Ngoc; Dang, Vu Phuong Linh

doi:10.1007/s00038-016-0937-2

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…Accordingly, multiple factors need to be considered and collectively illustrate the complexity of individualized HIV therapy. While the characteristics of drugs and the virus are well studied and mostly considered in treatment options [ 5 , 6 ], host characteristics are less well understood [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Torque Teno Virus plasma level as novel biomarker of retained immunocompetence in HIV-infected patients

et al. 2021

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Purpose To predict the course of immune recovery (IR) in HIV-1-infected patients after initiation of combined antiretroviral therapy (cART) by determination of the plasma concentration of Torque Teno Virus (TTV). TTV has been identified as marker for risk assessment in immunosuppressed patients after transplantation procedures. Here, TTV was analyzed in HIV-1-infected therapy-naïve patients to evaluate its use as predictor of the course of IR for guidance of individualized treatment. Methods TTV DNA was quantified in plasma samples of 301 therapy-naïve HIV-1-infected patients and correlated to CD4+ cell count, HIV viral load, presence of the herpes viruses CMV, EBV and HHV-8, age and sex. Patients were classified according to their initial CD4+ cell count and to the extent of CD4+ T-cell increase within the first year of cART. Results TTV DNA was detectable in 96% of the patients’ plasma samples with a median TTV plasma concentration of 5.37 log10 cop/ml. The baseline CD4+ cell count was negatively correlated with TTV plasma concentration (p = 0.003). In patients with a CD4+ cell recovery < 50 cells/µl, the median TTV plasma concentration was significantly higher compared to patients with a CD4+ cell recovery of > 200 CD4+ cells/µl (5.68 log10 cop/ml versus 4.99 log10 cop/ml; p = 0.011). TTV plasma concentration in combination with baseline CD4+ cell count were significantly correlated to CD4+ cell recovery (p = 0.004). For all other parameters considered, no significant correlation for CD4+ cell recovery was found. Conclusion Within the cohort, the significantly elevated TTV plasma concentration in patients with diminished CD4+ cell recovery indicates a more profound immune defect. Baseline TTV plasma concentrations and CD4+ cell count are predictive for the course of immune recovery in HIV-1-infected patients with severe immunodeficiency.

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Section: Introductionmentioning

confidence: 99%

Torque Teno Virus plasma level as novel biomarker of retained immunocompetence in HIV-infected patients

et al. 2021

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“…[8][9][10]12 In a cohort of 266 HIV-infected children with suspected tuberculosis (TB) in four countries (Burkina Faso, Cambodia, Cameroon, and Vietnam), Marcy et al found that TB, young age, CD4 less than 10%, miliary features, and elevated serum transaminases were all independent predictors of mortality. 13 In Vietnam, by the end of 2011, there were 3200 Vietnamese children with HIV/AIDS receiving ART; However, there were a few reports on ART outcomes among HIV-infected children [14][15][16] In a study of 86 children on ART in Hanoi, Vietnam, Pham et al reported that the success rate (plasma HIV-1 viral load <1000 copies/mL) was 79.1% after 2-year follow-up. 14 As far as this author knows, no studies to evaluate long-term ART outcomes for infected-HIV children have been conducted in Vietnam.…”

Section: Introductionmentioning

confidence: 99%

<p>Long-Term Outcomes and Risk Factors for Mortality in a Cohort of HIV-Infected Children Receiving Antiretroviral Therapy in Vietnam</p>

Nguyen¹,

Ton²,

Luong³

et al. 2020

HIV

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Background: Management of HIV-infected children on a long-term basis is a challenge in resource-limited countries. The aim of this study is to evaluate the long-term outcome and identify the risk factors for mortality in a cohort of children with antiretroviral therapy (ART) in Vietnam. Patients and Methods: A retrospective cohort study was conducted in children aged 0-15 years, seen at the outpatient clinic of the Women and Children Hospital of An Giang, Vietnam, from August 2006 to May 2019. Cox proportional-hazard models were used to determine factors associated with mortality. Results: A total of 266 HIV-infected children were on ART. During 1545 child-years of follow-up (median follow-up was 5.8 years), 28 (10.5%) children died yielding a mortality rate of 1.8 death per 100 child-years. By multivariate analysis, World Health Organization clinical stage 3 or 4 (AHR; 7.86, 95% CI; 1.02-60.3, P= 0.047), tuberculosis (TB) coinfection (AHR; 6.26, 95% CI; 2.50-15.64, P= 0.001) and having severe immunosuppression before ART (AHR; 11.73, 95% CI; 1.52-90.4, P= 0.018) were independent factors for mortality in these children. Conclusion: Antiretroviral therapy has reduced mortality in HIV-infected children in resource-limited settings. Independent risk factors for mortality were advanced clinical stage (3 or 4), TB co-infection and severe immunosuppression. Early investigation and treatment of TB co-infection allow early ART initiation which may improve outcomes in our settings.

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“…Using multivariable regression, we found a strong correlation between HAZ and CD4 T‐cell count, and between HAZ and CD4 T‐cell percentage. We have shown that CD4 T‐cell count and CD4 T‐cell percentage have a great advantage in the prognosis of TF; therefore HAZ might be a good marker to monitor treatment response. In addition, height could be the most sensitive growth marker in the monitoring of disease progression.…”

Section: Discussionmentioning

confidence: 99%

Growth in children infected with HIV receiving anti‐retroviral therapy in Vietnam

Dang

Pham

Dinh

et al. 2019

Pediatrics International

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Background: There are currently two markers used to monitor treatment response to anti-retroviral therapy (ART) in HIV-infected children: CD4 T-cell count and HIV viral load; but analysis of these could be challenging in resource-poor countries. The aim of this study was therefore to determine whether change in growth parameters such as weight-for-age Z score (WAZ), height-for-age Z score (HAZ) and body mass index-for-age Z score (BMIZ) is associated with treatment response in HIV-infected children.Methods: This was a nested case-control study, in which the data were collected at enrolment and then periodically every 6 months for a total 36 month follow up of 107 HIV-infected children enrolled and treated at National Hospital of Pediatrics, Vietnam. Results: At treatment initiation, WAZ, HAZ and BMIZ were not significantly higher in the treatment success (TS) group compared with the treatment failure (TF) group. After ART initiation, WAZ and HAZ increased, and this was significant in the TS group (from À1.5 to À0.54, P < 0.01 and from À2.06 to À0.84, P < 0.01, respectively). Low HAZ was significantly associated with TF (HR, 0.71; 95% CI: 0.54-0.92). Conclusion: Height-for-age Z score was the most sensitive growth parameter in prediction of the treatment response. In order to use growth parameters, particularly HAZ as a prognosis marker for TF in clinical practice, further research should be conducted to evaluate the role of growth parameters and their effects on treatment response.

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Clinical characteristics of pediatric HIV-1 patients treated with first-line antiretroviral therapy in Vietnam: a nested case–control study

Abstract: There is an inherent complexity within clinical markers that is challenging to determine HIV-pediatric failure and further research is needed to build a complete picture to guide clinical, evidence-based practice.

Cited by 4 publications

References 22 publications

Torque Teno Virus plasma level as novel biomarker of retained immunocompetence in HIV-infected patients

Torque Teno Virus plasma level as novel biomarker of retained immunocompetence in HIV-infected patients

<p>Long-Term Outcomes and Risk Factors for Mortality in a Cohort of HIV-Infected Children Receiving Antiretroviral Therapy in Vietnam</p>

Growth in children infected with HIV receiving anti‐retroviral therapy in Vietnam

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