Fabrice Monpoux, Amandine Rubio, Charlotte Sakarovitch, Eric Fontas, Jacqueline Cottalorda-Dufayard and Christian Pradier
Background: It is now widely accepted that the antiretroviral first line-treatment basis in HIV-1 infected children is a combination of 2 nucleoside reverse transcriptase inhibitors and 1 protease inhibitor or 1 non NRTI. However, after few months or years, some patients presented with virological failure. Objective: Using a “real life conditions” cohort, we aimed to study the median duration of Viral Controlled Replication (VCR) and the factors associated with failure in infected children. Methods: Thirty six HIV-1 infected patients were followed between September 1996 and September 2010. Children were included starting from the date of initiation of their first successful HAART. Duration of effective VCR was defined as a length, in months, from inclusion to virological failure defined as a HIV-1 PCR-RNA higher than 400 c/ml. Results: The overall median VCR duration was 46.2 months. Duration was significantly shorter in patients: previously exposed to mono therapies, with CD4 count lower than 350 and with PI-based HAART. After adjustment, the negative effect of PI-based HAART regimen compared to nNRTI-based HAART remained significant (HR=5.7 [95%CI=1.43-22.7]). Conclusion: Therefore, retrospective analysis of “real life” condition data in observational cohort may contribute to a better understanding of non optimal virological care.
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