Prevalence and Clinical Outcomes of Poor Immune Response Despite Virologically Suppressive Antiretroviral Therapy Among Children and Adolescents With Human Immunodeficiency Virus in Europe and Thailand: Cohort Study

摘要: Background. In human immunodeficiency virus (HIV).positive adults, low CD4 cell counts despite fully suppressed HIV-1 RNA on antiretroviral therapy (ART) have been associated with increased risk of morbidity and mortality. We assessed the prevalence outcomes poor immune response (PIR) in children receiving suppressive ART. Methods. Sixteen cohorts from European Pregnancy Paediatric HIV Cohort Collaboration (EPPICC) contributed data. Children <18 years at ART initiation, sustained viral suppression (VS) (.400 copies/mL) for ≥1 year were included. The PIR (defined as World Health Organization advanced/severe immunosuppression age) 1 VS was described. Factors using logistic regression. Rates acquired syndrome (AIDS) or death calculated by status. Results. Of 2318 included, median age 6.4 68% had initiation. At VS, 12% PIR. multivariable analysis, older worse immunological stage start, hepatitis B coinfection, residing Thailand (all P ≤ .03). AIDS/death (95% confidence interval) per 100 000 person-years 1052 (547, 2022) among versus 261 (166, 409) responders; rate ratio 4.04 (1.83, 8.92; < .001). Conclusions. One eight our cohort experienced VS. While overall low, a 4-fold increase event compared responders.