[MoAb0203] Outcomes of children, stratified by immune status, receiving anti-retroviral therapy (ART) in Médecins Sans Frontières (MSF)-supported projects in resource-poor countries (RPCS)

16th International AIDS Conference

Toronto, Canada - August 13 - 18, 2006

OUTCOMES OF CHILDREN, STRATIFIED BY IMMUNE STATUS, RECEIVING ANTI-RETROVIRAL THERAPY (ART) IN MÉDECINS SANS FRONTIÈRES (MSF)-SUPPORTED PROJECTS IN RESOURCE-POOR COUNTRIES (RPCS)

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. MoAb0203

Olson D.¹, Sauvageot D.², Ferradini L.², O' Brien D.³, Humblet P.⁴, The MSF AIDS Working Group
¹Médecins Sans Frontières, New York, United States, ²Epicentre, Paris, France, ³Médecins Sans Frontières, Amsterdam, Netherlands, ⁴Médecins Sans Frontières, Brussels, Belgium

BACKGROUND: Despite scale-up of ART in RPCs, treatment of children lags behind that of adults. Globally, less than 5% of eligible children receive ART. Those who do tend to be older and data on treatment outcomes of younger children in RPCs remain scarce.

METHODS: A retrospective analysis was performed of baseline characteristics and treatment outcomes in MSF-supported HIV-treatment projects collected with FUCHIA database software (Epicentre, Paris). There were 15 projects in Africa, Asia, and Central America. Results for children aged 18 to 59 months were grouped according to pre-ART immunosupression (IS): Profound IS (CD4 < 5%) or Severe IS (5% ≤ CD4 < 15%).

RESULTS: Data on 195 children were available for analysis. 98% were ART-naïve and 95% received an NNRTI-based regimen. 49 (45% female) had baseline Profound IS with median age of 45.6 months (IQR: 36-52); 28.6 and 54.8% were CDC clinical stage B and C, respectively. There were 146 (41% female) with Severe IS, with median age of 37.3 months (28.9-48.5); 30.8 and 35.3% were clinical stage B and C, respectively. Two-thirds of each cohort had received ART less than 12 months, while 14 and 20% in the Profound and Severe IS groups, respectively, had been on ART for 12-24 months. Probability of survival (not deceased or lost to follow-up) was 0.85 (0.71-0.93) at both 6 and 12 months in the Profound IS group, and 0.95 (0.93-0.99), 0.94 (0.88-0.97), 0.85 (0.69-0.83) at 6, 12 , and 24 months in the Severe IS group. At 6 months, median CD4% was 11.8 (9.9-17.4) and 20.6 (15.2-25.7) and median CD4% gain was 11.5 (8.1-14.9) and 11.5 (7.4-15.4) in the two groups, respectively.

	Profound IC (N=49)	Severe IC (N=146)
Female, %	45	41
Median age (IQR), m	45.6 (36-52)	37.3 (28.9-48.5)
CDC clinical stage	N= 42	N=133
% N	9.5	12.0
A	7.1	21.8
B	28.6	30.8
C	54.8	35.3

	Profound IC (N=49)	Severe IC (N=146)
Duration of ART: < 12 m	65%	66%
12-24 m	14%	20%
*Probability of Success:**
At 6 months (n, IQR)	0.85 (31, 0.71-0.93)	0.95 (91, 0.93-0.99)
At 12 months (n, IQR)	0.85 (18, 0.71-0.93)	0.94 (51, 0.88-0.97)
At 24 months (n, IQR)		0.85 (22, 0.69-0.83)
Immunologic Evolution at 6 months	N=11	N=43
Median CD4% (IQR)	11.8 (9.9-17.4)	20.6 (15.2-25.7)
Median gain CD4% (IQR)	11.5 (8.1-14.9)	11.5 (7.4-15.4)

CONCLUSIONS: Young children can be successfully treated with ART in RPCs, as measured by treatment continuation and immunologic criteria. Extent of baseline IS does not appear to impact on treatment outcome by month 12.

Download PDF of this abstract.

Download MSF Poster in PDF Format.

2006-08-13
MoAb0203

Copyright © 2006 - International AIDS Society (IAS). All information and content relating to the abstracts from the 16th International AIDS Conference, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is a 501c(3) not-for-profit organization made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, GlaxoSmithKline, the National Library of Medicine, Roche / Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.