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Home >> Publications >> HIV-infected children in the Asia-Pacific region with baseline severe anemia: antiretroviral therapy and outcomes.

Publication

Author(s):

Lumbiganon P1, Kosalaraksa P1, Bunupuradah T2, Boettiger D3, Saphonn V4, Truong KH5, Kurniati N6, Hansudewechakul R7, Do VC8, Sudjaritruk T9, Kumarasamy N10, Kongstan N11, Yusoff NK12, Nguyen LV13, Wati DK14, Razali K15, Sohn AH16, Kariminia A3.

Pub Title:

HIV-infected children in the Asia-Pacific region with baseline severe anemia: antiretroviral therapy and outcomes.

Pub Date:

Jun 1 2016

Pub Region(s):

Asia-Pacific

Journal:

Title: 
Asian Biomed

PubMed: 28239430
Pub PDF:

BACKGROUND: Severe anemia is common among children infected with human immunodeficiency virus (HIV). The choice of antiretroviral (ART) regimen needs careful consideration. No information is available regarding the initial ART regimens used in the Asia-Pacific region and the rate of switch of ART regimens in HIV-infected children with severe anemia.

OBJECTIVES: To study the initial ART regimens and the rate of switch of ART regimens used during the first 36 months in HIV-infected children with severe anemia and to evaluate their clinical and laboratory outcomes.

METHODS: We analyzed regional cohort data of 130 Asian children aged <18 years with baseline severe anemia (hemoglobin <7.5 g/dl) who started antiretroviral therapy (ART) between January 2003 and September 2013.

RESULTS: At ART initiation, median age was 3.5 years old (interquartile range (IQR) 1.7 to 6.3) and median hemoglobin was 6.7 g/dL (IQR 5.9-7.1, range 3.0-7.4). Initial ART regimens included stavudine (85.4%), zidovudine (13.8%), and abacavir (0.8%). In 81 children with available hemoglobin data after 6 months of ART, 90% recovered from severe anemia with a median hemoglobin of 10.7 g/dL (IQR 9.6-11.7, range 4.4-13.5). Those starting AZT-based ART had a mortality rate of 10.8 (95% confidence interval (CI) 4.8-23.9) per 100 patient-years compared to 2.7 (95% CI 1.6-4.6) per 100 patient-years among those who started d4T-based ART.

CONCLUSIONS: With the phase-out of stavudine, age-appropriate non-zidovudine options are needed for younger Asian children with severe anemia.

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Citation:

Asian Biomed (Res Rev News). 2016 Jun;10(3):229-234. HIV-infected children in the Asia-Pacific region with baseline severe anemia: antiretroviral therapy and outcomes. Lumbiganon P1, Kosalaraksa P1, Bunupuradah T2, Boettiger D3, Saphonn V4, Truong KH5, Kurniati N6, Hansudewechakul R7, Do VC8, Sudjaritruk T9, Kumarasamy N10, Kongstan N11, Yusoff NK12, Nguyen LV13, Wati DK14, Razali K15, Sohn AH16, Kariminia A3.