Background: The introduction of HAART has decreased mortality and progression to AIDS in perinatally HIV-1-infected children, but information on modification of the rate of specific clinical events is limited. Method: An observational population study on changes in HIV-1-related morbidity was conducted on 1402 perinatally HIV-1-infected children enrolled in the Italian Register for HIV Infection in Children and prospectively followed in the pre-HAART (1985-1995) and post-HAART periods (1996-2000, and 2001 -2005). Of this group, 773 children (55.1%) were followed from birth. Median observation time was 8.58 years (interquartile range, 3.71-13.72). Results: Overall, 666 (47.5%) children developed AIDS and 420 (29.9%) died. improved survival over time was evidenced at Kaplan-Meier analysis (P < 0.0001). Poisson regression analysis indicated that Centers for Disease Control and Prevention class B and C clinical event rates and most of the HIV-1-related organ complication rates significantly decreased starting from 1996-2000. Significant reductions in rates of cancer and opportunistic infections were evidenced after 2000. Nevertheless, opportunistic infections still occurred at high rates (6.09/100 person-years) in 2001-2005, with high rate of bacterial infections (3.55/100 person-years), particularly pneumonia (1.66/100 person-years), in this period. CD4 cell percentage was > 15% in 58.5% children with pneumonia. Conclusions: Progressive reductions of both mortality and rates of class B and C clinical events, including organ complications, were evidenced in the HAART era. Nevertheless, severe bacterial infections, particularly pneumonia, still occurred at considerable high rates, even in the absence of a severe CD4 cell depletion. (c) 2007 Lippincott Williams & Wilkins.
|Autori:||WRITING COMMITTEE CHIAPPINI E; GALLI L; TOVO PA; GABIANO C; LISI C; GATTINARA GC; ESPOSITO S; VIGANÒ A; GIAQUINTO C; ROSSO R; GUARINO A; DE MARTINO M. MEMBERS OF THE ITALIAN REGISTER FOR HIV INFECTION IN CHILDREN P. OSIMANI; R. CORDIALI; D. DE MATTIA; M. MANZIONNA; C. DI BARI; M. RUGGERI; M. MASI; A. MINIACI; F. SPECCHIA; M. CICCIA; M. LANARI; F. BALDI; L. BATTISTI; R. SCHUMACHER; M. DUSE; M. SINELLI; V. BENNATO; C. DESSÌ; M. DEDONI; M.L. FENU; R. CAVALLINI; E. ANASTASIO; D. ZICCHINELLA; M. STICCA; G. POMERO; R. CONTIERO; E. FIUMANA; P. GERVASO; G. GABRIELLI; G. BRACCESI; S. BECHERUCCI; M. DE GAUDIO; L. INNOCENTI; M.T. CECCHI; F. GINOCCHIO; L.A. NICOLINI; B.W. CIRAVEGNA; D. COSSO; A. TIMITILLI; M. STRONATI; A. PLEBANI; J. BOJANIN; A. PORTA; N. PRINCIPI; V. GIACOMET; R. BIANCHI; G.V. ZUCCOTTI; M. GIOVANNINI; G. FERRARIS; R. LIPRERI; C. MORETTI MILANO; M. CELLINI; M.C. CANO; G. PALAZZI; E. BRUZZESE; A. GIANNATTAZIO; L. TARALLO; F. TANCREDI; R. D'ELIA; O. RAMPON; E.R. DALLE NOGARE; A. SANFILIPPO; A. ROMANO; M. SAITTA; I. DODI; A. BARONE; CONSOLINI R; A. LEGITIMO; C. MAGNANI; P. FALCONIERI; C. FUNDARÒ; P. VALENTINI S. SALVUCCI; A.M. CASADEI; S. BERNARDI; P. PALMA; M. ANZIDEI; S. CERILLI; S.; C. AJASSA; A. GANAU; L. CRISTIANO; A. MAZZA; L. GENTILINI; F. MIGNONE; A. VERSACE; E. ANTONIELLI; S. SOVATZIS; C. SCOLFARO; E. PALOMBA; V. PORTELLI; M. RABUSIN; A. PELLEGATTA; P. FORTUNATI|
|Titolo:||Changing patterns of clinical events in perinatally HIV-1-infected children during the era of HAART. The Italian Register for HIV Infection in Children|
|Anno del prodotto:||2007|
|Digital Object Identifier (DOI):||10.1097/QAD.0b013e32823ecf5b|
|Appare nelle tipologie:||1.1 Articolo in rivista|