PMID- 16988517
OWN - NLM
STAT- MEDLINE
DCOM- 20071024
LR  - 20220408
IS  - 0269-9370 (Print)
IS  - 0269-9370 (Linking)
VI  - 20
IP  - 15
DP  - 2006 Oct 3
TI  - In resource-limited settings good early outcomes can be achieved in children 
      using adult fixed-dose combination antiretroviral therapy.
PG  - 1955-60
AB  - OBJECTIVES: To (a) determine early treatment outcomes and (b) assess safety in 
      children treated with adult fixed-dose combination (FDC) antiretroviral tablets. 
      SETTING: Sixteen Medecins Sans Frontieres (MSF) HIV programs in eight countries 
      in resource-limited settings (RLS). METHODS: Analysis of routine program data 
      gathered June 2001 to March 2005. RESULTS: A total of 1184 children [median age, 
      7 years; inter-quartile range (IQR), 4.6-9.3] were treated with antiretroviral 
      therapy (ART) of whom 616(52%) were male. At ART initiation, Centres for Disease 
      Control stages N, A, B and C were 9, 14, 38 and 39%, respectively. Children were 
      followed up for a median period of 6 months (IQR, 2-12 months). At 12 months the 
      median CD4 percentage gain in children aged 18-59 months was 15% (IQR, 6-18%), 
      and the percentage with CD4 gain < 15% was reduced from 85% at baseline to 11%. 
      In those aged 60-156 months, median CD4 cell count gain was 275 cells/microl 
      (IQR, 84-518 cells/microl), and the percentage with CD4 < 200 cells/mul reduced 
      from 51% at baseline to 11%. Treatment outcomes included; 1012 (85%) alive and on 
      ART, 36 (3%) deaths, 15 (1%) stopped ART, 89 (8%) lost to follow-up, and 31 (3%) 
      with unknown outcomes. Overall probability of survival at 12 months was 0.87 
      (0.84-0.89). Side effects caused a change to alternative antiretroviral drugs in 
      26 (2%) but no deaths. CONCLUSIONS: Very satisfactory early outcomes can be 
      achieved in children in RLS using generic adult FDC antiretroviral tablets. These 
      findings strongly favour their use as an "interim solution" for scaling-up ART in 
      children; however, more appropriate pediatric antiretroviral drugs remain 
      urgently needed.
FAU - O'Brien, Daniel P
AU  - O'Brien DP
AD  - AIDS Working Group, Medecins Sans Frontieres, Plantage Middenlaan 14, 1001 EA 
      Amsterdam, The Netherlands. daniel.obrien@amsterdam.msf.org
FAU - Sauvageot, Delphine
AU  - Sauvageot D
FAU - Zachariah, Rony
AU  - Zachariah R
FAU - Humblet, Pierre
AU  - Humblet P
CN  - Medecins Sans Frontieres
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - AIDS
JT  - AIDS (London, England)
JID - 8710219
RN  - 0 (Anti-Retroviral Agents)
SB  - IM
MH  - Africa
MH  - Anti-Retroviral Agents/*administration & dosage/economics/therapeutic use
MH  - Asia, Southeastern
MH  - CD4 Lymphocyte Count
MH  - Child
MH  - Child, Preschool
MH  - *Developing Countries
MH  - Drug Administration Schedule
MH  - Drug Costs
MH  - Female
MH  - HIV Infections/*drug therapy/immunology/mortality
MH  - Humans
MH  - Male
MH  - Safety
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2006/09/22 09:00
MHDA- 2007/10/25 09:00
CRDT- 2006/09/22 09:00
PHST- 2006/09/22 09:00 [pubmed]
PHST- 2007/10/25 09:00 [medline]
PHST- 2006/09/22 09:00 [entrez]
AID - 00002030-200610030-00008 [pii]
AID - 10.1097/01.aids.0000247117.66585.ce [doi]
PST - ppublish
SO  - AIDS. 2006 Oct 3;20(15):1955-60. doi: 10.1097/01.aids.0000247117.66585.ce.