TY - JOUR
TI - CD4 recovery following antiretroviral treatment interruptions in
children and adolescents with HIV infection in Europe and Thailand
AU - Galli, L.
AU - Crichton, S.
AU - Buzzoni, C.
AU - Goetghebuer, T. and
AU - Jourdain, G.
AU - Judd, A.
AU - Klein, N.
AU - Jose Mellado, M. and
AU - Noguera-Julian, A.
AU - Kahlert, C. R.
AU - Spoulou, V.
AU - Scherpbier, H.
AU - and Marques, L.
AU - Collins, I. J.
AU - Gibb, D. M.
AU - Gonzalez Tome, Mi
AU - and Warszawski, J.
AU - Dollfus, C.
AU - Koenigs, C.
AU - Prata, F. and
AU - Chiappini, E.
AU - Naver, L.
AU - Giaquinto, C.
AU - Thorne, C. and
AU - Marczynska, M.
AU - Okhonskaia, L.
AU - Borkird, T.
AU - Attavinijtrakarn,
AU - P.
AU - Malyuta, R.
AU - Volokha, A.
AU - Ene, L.
AU - Goodall, R. and
AU - European Pregnancy Paediat HIV
JO - Neurobehavioral HIV Medicine
PY - 2019
VL - 20
TODO - 7
SP - 456-472
PB - Wiley
SN - null
TODO - 10.1111/hiv.12745
TODO - antiretroviral therapy; paediatric; treatment interruption
TODO - Objectives The aim of the study was to explore factors associated with
CD4 percentage (CD4%) reconstitution following treatment interruptions
(TIs) of antiretroviral therapy (ART). Methods Data from paediatric
HIV-infected cohorts across 17 countries in Europe and Thailand were
pooled. Children on combination ART (cART; at least three drugs from at
least two classes) for > 6 months before TI of >= 30 days while aged
CD4% at restart of ART (r-ART) and in the long term (up to 24 months
after r-ART) following the first TI was modelled using asymptotic
regression. Results In 779 children with at least one TI, the median age
at first TI was 10.1 [interquartile range (IQR) 6.4, 13.6] years and
the mean CD4% was 27.3% [standard deviation (SD) 11.0%]; the median
TI duration was 9.0 (IQR 3.5, 22.5) months. In regression analysis, the
mean CD4% was 19.2% [95% confidence interval (CI) 18.3, 20.1%] at
r-ART, and 27.1% (26.2, 27.9%) in the long term, with half this
increase in the first 6 months. r-ART and long-term CD4% values were
highest in female patients and in children aged TI. Long-term CD4% was
highest in those with a TI lasting 1 to <3 months, those with r-ART
after year 2000 and those with a CD4% nadir >= 25% (all P < 0.001).
The effect of CD4% nadir during the TI differed significantly (P =
0.038) by viral suppression at the start of the TI; in children with
CD4% nadir TI, recovery was better in those virally suppressed prior to
the TI; viral suppression was not associated with recovery in children
with CD4% nadir >= 25%. Conclusions After restart of ART following TI,
most children reconstituted well immunologically. Nevertheless, several
factors predicted better immunological reconstitution, including younger
age and higher nadir CD4% during TI.
ER -