Hepatotoxicity of antiretrovirals in patients with human immunodeficiency virus and viral hepatitis coinfections

Abstract

Background: Perinatal HIV-infected children survive and live close to normal life from the effect of highly active antiretroviral therapy (HAART). The information of these grown-up children and adolescents in Thailand has been limited. Objectives: To describe the demographic, HIV-related health status, and social characteristics of perinatal HIV-infected adolescents at Siriraj Hospital, Mahidol University.Methods: This is a cross-sectional descriptive analysis of demographic, CD4, HIV-RNA, antiretroviral therapy (ART), education, and living status of adolescents, ages 12-18 years old who were followup at Siriraj hospital. Data were collected from medical record in January 2010.Results: Of the 81 adolescents, mean age 14.7 years, 41 (50.6%) were female. Fifty four (66.7%) were living with biological father and/or mother, 22 (27.2%) living with relatives, and 5 (6.2%) living in foster families. Ninety-eight percent were attending regular school, while 2.5% had left school. By self report, 32 (39.5%) were sexually active. Of the 81 adolescents with medical information available, 69 (85.2%) had HIV RNA < 40 copies/mL, and 78 (96.3%) had CD4 > 200 cells/mm3. Forty-one (50.6%) were receiving protease inhibitor-based regimens, 38 (46.9%) receiving non nucleoside reverse transcriptase inhibitor-based regimens, and 2 (2.5%) receiving lamivudine monotherapy holding regimen, mostly from poor adherence. Conclusion:Perinatal HIV-infected adolescents in Bangkok were in good immunologic status but a quarter had virologic failure. Social and education supports should be included in comprehensive care to improve the outcomes.