Background: Antiretroviral therapy (ART) significantly improved prognosis of HIV-infected children. We assessed response to treatment and morbidity among HIV+ children in Israel.
Methods: Demographic, laboratory, clinical and treatment data of HIV+ children from 5 pediatric centers was collected retrospectively. Target CD4/viral load (VL) were defined as CD4 ≥500 cells/mm3 at ≥6 years, ≥25% at
Results: Overall, 133 children (59 males, 100 of African origin) were assessed; ART was prescribed to 118 (88.7%) (median duration 7.4 years). Target CD4 and VL were achieved in 105/116 (90.5%) and 101/110 (91.8%) children, respectively. At the end of follow-up, the respective numbers were 83/115 (72.2%) for CD4 and 89/110 (80.9%) for VL. In multivariate analysis only duration of treatment >5 years predicted achievement of target CD4, but also VL re-elevation after initial suppression. There were no differences between children from African vs. non-African origin.
Laboratory treatment side effects (n=114) occurred in 86/118 (72.8%) children, 5 (4.8%) were severe, without mortality. The most frequent were increased plasma lipid levels (34%) and neutropenia (30%). Overall, 44 (37.2%) children had 95 hospitalizations, 67.3% due to infections, 32.6% due to pneumonia. Hospitalization rate decreased significantly with time on ART, as well as the proportion of infectious causes of hospitalizations.
BMI scores were compatible with those of healthy children.
Conclusions: HIV+ children in Israel have good response to therapy. ART is associated with normal growth and decreased need for hospitalizations. Awareness of ART side effects is important.
This study was sponsored by HIPAK 2014 grant.
