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Opportunistic infections significant cause of morbidity in Asian children on HAART
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In children with HIV, opportunistic infections remain significant causes of morbidity after highly active antiretroviral therapy initiation, despite declines in their incidence, according to recent study findings published in The Pediatric Infectious Disease Journal.
Wasana Prasitsuebsai, MD, MPH, of The HIV Netherlands Australia Thailand Research Collaboration in Thailand, and colleagues evaluated 2,280 children to determine the frequency of opportunistic infections in Asian children after initiation of HAART. Data were collected from the TREAT Asia Pediatric HIV Observational Database cohort study from March 1993 to March 2009.
Seventy-seven percent of all patients had ever received ART; 84% initiated treatment with HAART and 16% started mono or dual non-nucleoside reverse transcriptase inhibitor (NRTI) therapy. Of those patients on mono or dual therapy, 89% started their first treatment between 1995 and 2004. However, 97.5% of patients on HAART started treatment after 2002.
The incidence rate of opportunistic infections during mono or dual therapy was 28.8 infections per 100 person-years and 10.5 opportunistic infections per 100 person-years during HAART. Upper respiratory tract infection, oral candidiasis and pulmonary tuberculosis were the most common opportunistic infections.
Ninety-nine deaths occurred after HAART and 36 during the time after any ART. Sixty-three percent were caused by opportunistic infection and other infections. Eighty percent of the deaths that occurred during the first 6 months of ART were opportunistic infection-related.
“The overall rate of opportunistic infections after HAART was found to be lower than after mono or dual therapy (10.5 vs. 28.8 per 100 person-years), as opportunistic infection incidence fell with time after initiating ART and children who were receiving HAART had a longer period of follow-up than those who received mono or dual therapy,” the researchers wrote. “Most of the children who received mono or dual therapy were switched to HAART and were then censored from the analysis.”
Disclosure: See study for a full list of researchers’ financial disclosures.
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