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Antiretroviral therapy vs. antiretroviral therapy + intra-venous immunoglobulin in pediatric AIDS: a clinical and survival analysis.


Int Conf AIDS. 1996 Jul 7-12;11(2):112 (abstract no. We.B.3323). Unique

Objectives: To compare the incidence of infectious events and survival among 2 groups of HIV-infected children submitted to 2 different therapeutic regimens: Anti-retroviral therapy (ARVT) and Anti-retroviral therapy plus immunoglobulin (ARVT+IVIG). Methods: A total of 144 HIV-infected children were followed from January/1988 to December/1995 in 2 different centers, in Sao Paulo, Brazil. Seventy children were followed in center "A" and received ARVT (Group A) while 74 children were followed in center B" and received IVIG monthly therapy prior to the association of ARVT. All the children received SMZ-TMP after the introduction of ARVT. Age adjusted rates of mild, moderate and severe infections were analyzed in each group before and after the introduction of ARVT as well as global survival. The values were summarized by median and their distribution compared by Mann-Whitney test. Survival analysis was done by Kaplan-Meier method; mean survival was estimated by hazard function with CI 95%. A significance level of 5% was adopted (p is less than 0.005). Results: In group A age at the end of the study varied from 12 to 106 months median=51.7) and 55% were male, while in group B age varied from 23 to 130 months (median =67) and 42% were male. Median age at the beginning of follow up was 17.1 and 22.0 mo., median age at introduction of ARVT was 25.0 and 48.0 mo., respectively in groups A and B. The median age at introduction of IVIG in group B was 25.0 mo. The median age at the beginning of the symptoms was 8.0 and 23 mo. in groups A and B. There were no statistical significant difference between the 2 groups concerning the annual rate of severe and moderate infections. Group B showed annual rate of mild infections 4.6 times smaller than group A, after the ARVT (p is less than 0.001). During follow up period 19 children died in group A and 17 in group B, with median survival of 52.9 and 60.4 respectively (p=0.09). The survival rate at the end of the study was 72.9 and 77.1% in groups A and B. The mean survival time estimated in group A was 194.7 mo. (CI 95%: 107.1-282.2) and in group B was 294.2 mo. (CI 95%: 154.3-434.1). DISCUSSION: The group that received IVIG prior to ARVT showed smaller rate of mild infections, with no differences concerning the moderate and severe infections. Despite the differentials observed in the survival rates, this data was not statistically significant due to the size of the sample or to the length of follow up. A more prolonged follow up of this population will give more conclusive data about survival rates.

*Acquired Immunodeficiency Syndrome/THERAPY *Antiviral Agents/THERAPEUTIC USE *Immunoglobulins, Intravenous/THERAPEUTIC USE *Retroviridae/DRUG EFFECTS


Information in this article was accurate in January 30, 1997. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.