Author | Oliveira, Ricardo | |
Author | Krauss, Margot | |
Author | Essama-Bibi, Suzanne | |
Author | Hofer, Cristina | |
Author | Robert Harris, D. | |
Author | Tiraboschi, Adriana | |
Author | Souza, Ricardo | |
Author | Marques, Heloisa | |
Author | Succi, Regina | |
Author | Abreu, Thalita Fernandes de | |
Author | Della Negra, Marinella | |
Author | Hazra, Rohan | |
Author | Mofenson, Lynne M. | |
Author | Siberry, George K. | |
Access date | 2018-11-22T17:25:04Z | |
Available date | 2018-11-22T17:25:04Z | |
Document date | 2010 | |
Citation | OLIVEIRA, Ricardo et al. Viral load predicts new world health organization stage 3 and 4 events in HIV-infected children receiving highly active antiretroviral therapy, independent of CD4 T lymphocyte value. Clinical Infectious Diseases, v. 51, n. 11, p. 1325-1333, Dec. 2010. | pt_BR |
ISSN | 1058-4838 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/30168 | |
Description | Presentes no NISDI Pediatric Study Group 2010: Beatriz Grinsztejn; Valdiléa Veloso (Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil). | pt_BR |
Language | eng | pt_BR |
Rights | restricted access | pt_BR |
Title | Viral load predicts new world health organization stage 3 and 4 events in HIV-infected children receiving highly active antiretroviral therapy, independent of CD4 T lymphocyte value | pt_BR |
Type | Article | pt_BR |
DOI | 10.1086/657119 | |
Abstract | Background: Many resource-limited countries rely on clinical and immunological monitoring without routine virological monitoring for human immunodeficiency virus (HIV)-infected children receiving highly active antiretroviral therapy (HAART). We assessed whether HIV load had independent predictive value in the presence of immunological and clinical data for the occurrence of new World Health Organization (WHO) stage 3 or 4 events (hereafter, WHO events) among HIV-infected children receiving HAART in Latin America. Methods: The NISDI (Eunice Kennedy Shriver National Institute of Child Health and Human Development International Site Development Initiative) Pediatric Protocol is an observational cohort study designed to describe HIV-related outcomes among infected children. Eligibility criteria for this analysis included perinatal infection, age <15 years, and continuous HAART for ≥6 months. Cox proportional hazards modeling was used to assess time to new WHO events as a function of immunological status, viral load, hemoglobin level, and potential confounding variables; laboratory tests repeated during the study were treated as time-varying predictors. Results: The mean duration of follow-up was 2.5 years; new WHO events occurred in 92 (15.8%) of 584 children. In proportional hazards modeling, most recent viral load >5000 copies/mL was associated with a nearly doubled risk of developing a WHO event (adjusted hazard ratio, 1.81; 95% confidence interval, 1.05-3.11; P = .033), even after adjustment for immunological status defined on the basis of CD4 T lymphocyte value, hemoglobin level, age, and body mass index. Conclusions: Routine virological monitoring using the WHO virological failure threshold of 5000 copies/mL adds independent predictive value to immunological and clinical assessments for identification of children receiving HAART who are at risk for significant HIV-related illness. To provide optimal care, periodic virological monitoring should be considered for all settings that provide HAART to children. | pt_BR |
Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Puericultura e Pediatria Martagão Gesteira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Westat. Rockville, Maryland, EUA. | pt_BR |
Affilliation | Westat. Rockville, Maryland, EUA. | pt_BR |
Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Puericultura e Pediatria Martagão Gesteira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Westat. Rockville, Maryland, EUA. | pt_BR |
Affilliation | Universidade de São Paulo. Faculdade de Medicina. Ribeirão Preto, SP, Brasil. | pt_BR |
Affilliation | Universidade de Caxias do Sul. Serviço Municipal de Infectologia. Caxias do Sul, Brasil. | pt_BR |
Affilliation | Universidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil. | pt_BR |
Affilliation | Universidade Federal de São Paulo. São Paulo, Brasil. | pt_BR |
Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Puericultura e Pediatria Martagão Gesteira. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Instituto de Infectologia Emilio Ribas. São Paulo, Brasil. | pt_BR |
Affilliation | National Institutes of Health. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Pediatric Adolescent Maternal AIDS Branch. Bethesda, Maryland, USA. | pt_BR |
Affilliation | National Institutes of Health. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Pediatric Adolescent Maternal AIDS Branch. Bethesda, Maryland, USA. | pt_BR |
Affilliation | National Institutes of Health. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Pediatric Adolescent Maternal AIDS Branch. Bethesda, Maryland, USA. | pt_BR |
Subject | HIV Infections | pt_BR |
Subject | Infant Newborn | pt_BR |
Subject | Antiretroviral Therapy | pt_BR |
Subject | CD4 Lymphocyte Count | pt_BR |
Subject | Severity of Illness Index | pt_BR |
Subject | Drug Monitoring | pt_BR |
Embargo date | 2025-08-30 | |