Determinants of highly active antiretroviral therapy duration in HIV-1-infected children and adolescents in Madrid, Spain, from 1996 to 2012.

<h4>Objectives</h4>To investigate the duration of sequential HAART regimens and predictors of first-line regimen discontinuation among HIV-1 vertically infected children and adolescents.<h4>Design</h4>Multicentre survey of antiretroviral-naïve patients enrolled in the HIV-Pae...

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Autores principales:	Claudia Palladino, Verónica Briz, José María Bellón, Francisco J Climent, Santiago J de Ory, María José Mellado, María Luisa Navarro, José T Ramos, Nuno Taveira, María Isabel de José, María Ángeles Muñoz-Fernández, CoRISpeS-Madrid Cohort Working Group
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/939eda59be3143199ea33fd218fecd6e
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spelling	oai:doaj.org-article:939eda59be3143199ea33fd218fecd6e2021-11-18T08:21:09ZDeterminants of highly active antiretroviral therapy duration in HIV-1-infected children and adolescents in Madrid, Spain, from 1996 to 2012.1932-620310.1371/journal.pone.0096307https://doaj.org/article/939eda59be3143199ea33fd218fecd6e2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24788034/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objectives</h4>To investigate the duration of sequential HAART regimens and predictors of first-line regimen discontinuation among HIV-1 vertically infected children and adolescents.<h4>Design</h4>Multicentre survey of antiretroviral-naïve patients enrolled in the HIV-Paediatric Cohor,t CoRISpeS-Madrid Cohort, Spain.<h4>Methods</h4>Patients with a follow-up of ≥ 1 month spent on HAART, with available baseline CD4 count and HIV-viral load (VL) were included. Time spent on sequential HAART regimens was estimated and multivariable regression was used to identify predictors of time to first-line regimen discontinuation.<h4>Results</h4>104 patients were followed for a median 8 years after starting HAART among 1996-2012; baseline %CD4 was 21.5 (12.3-34.0)and viral load was 5.1 (4.6-5.6) log10 copies/mL. Patients received a mean of 1.9 regimens. Median time on first-line HAART (n = 104) was 64.5 months; second HAART (n = 56) 69.8 months; and third HAART (n = 21) 66.5 months. Eleven (11%) patients were lost to follow-up while on first-line HAART and 54% discontinued (cumulative incidence of 16% and 38% by 1 and 3-year, respectively). The main predictor of first-line regimen discontinuation was suboptimal adherence to antiretrovirals (AHR: 2.60; 95% CI: 1.44-4.70).<h4>Conclusions</h4>Adherence to therapy was the main determinant of the duration of the first-line HAART regimen in children. It is important to identify patients at high risk for non-adherence, such as very young children and adolescents, in provide special care and support to those patients.Claudia PalladinoVerónica BrizJosé María BellónFrancisco J ClimentSantiago J de OryMaría José MelladoMaría Luisa NavarroJosé T RamosNuno TaveiraMaría Isabel de JoséMaría Ángeles Muñoz-FernándezCoRISpeS-Madrid Cohort Working GroupPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 5, p e96307 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Claudia Palladino Verónica Briz José María Bellón Francisco J Climent Santiago J de Ory María José Mellado María Luisa Navarro José T Ramos Nuno Taveira María Isabel de José María Ángeles Muñoz-Fernández CoRISpeS-Madrid Cohort Working Group Determinants of highly active antiretroviral therapy duration in HIV-1-infected children and adolescents in Madrid, Spain, from 1996 to 2012.
description	<h4>Objectives</h4>To investigate the duration of sequential HAART regimens and predictors of first-line regimen discontinuation among HIV-1 vertically infected children and adolescents.<h4>Design</h4>Multicentre survey of antiretroviral-naïve patients enrolled in the HIV-Paediatric Cohor,t CoRISpeS-Madrid Cohort, Spain.<h4>Methods</h4>Patients with a follow-up of ≥ 1 month spent on HAART, with available baseline CD4 count and HIV-viral load (VL) were included. Time spent on sequential HAART regimens was estimated and multivariable regression was used to identify predictors of time to first-line regimen discontinuation.<h4>Results</h4>104 patients were followed for a median 8 years after starting HAART among 1996-2012; baseline %CD4 was 21.5 (12.3-34.0)and viral load was 5.1 (4.6-5.6) log10 copies/mL. Patients received a mean of 1.9 regimens. Median time on first-line HAART (n = 104) was 64.5 months; second HAART (n = 56) 69.8 months; and third HAART (n = 21) 66.5 months. Eleven (11%) patients were lost to follow-up while on first-line HAART and 54% discontinued (cumulative incidence of 16% and 38% by 1 and 3-year, respectively). The main predictor of first-line regimen discontinuation was suboptimal adherence to antiretrovirals (AHR: 2.60; 95% CI: 1.44-4.70).<h4>Conclusions</h4>Adherence to therapy was the main determinant of the duration of the first-line HAART regimen in children. It is important to identify patients at high risk for non-adherence, such as very young children and adolescents, in provide special care and support to those patients.
format	article
author	Claudia Palladino Verónica Briz José María Bellón Francisco J Climent Santiago J de Ory María José Mellado María Luisa Navarro José T Ramos Nuno Taveira María Isabel de José María Ángeles Muñoz-Fernández CoRISpeS-Madrid Cohort Working Group
author_facet	Claudia Palladino Verónica Briz José María Bellón Francisco J Climent Santiago J de Ory María José Mellado María Luisa Navarro José T Ramos Nuno Taveira María Isabel de José María Ángeles Muñoz-Fernández CoRISpeS-Madrid Cohort Working Group
author_sort	Claudia Palladino
title	Determinants of highly active antiretroviral therapy duration in HIV-1-infected children and adolescents in Madrid, Spain, from 1996 to 2012.
title_short	Determinants of highly active antiretroviral therapy duration in HIV-1-infected children and adolescents in Madrid, Spain, from 1996 to 2012.
title_full	Determinants of highly active antiretroviral therapy duration in HIV-1-infected children and adolescents in Madrid, Spain, from 1996 to 2012.
title_fullStr	Determinants of highly active antiretroviral therapy duration in HIV-1-infected children and adolescents in Madrid, Spain, from 1996 to 2012.
title_full_unstemmed	Determinants of highly active antiretroviral therapy duration in HIV-1-infected children and adolescents in Madrid, Spain, from 1996 to 2012.
title_sort	determinants of highly active antiretroviral therapy duration in hiv-1-infected children and adolescents in madrid, spain, from 1996 to 2012.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/939eda59be3143199ea33fd218fecd6e
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Determinants of highly active antiretroviral therapy duration in HIV-1-infected children and adolescents in Madrid, Spain, from 1996 to 2012.

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