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.