TREATMENT EFFECTIVENESS AND SIDE EFFECTS OF ARV MEDICINES IN HIV INFECTED CHILDREN AT VIETNAM NATIONAL CHILDREN’S HOSPITAL
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Abstract
Objective: Review the treatment effectiveness and side effects of ARV drugs in HIVinfected children at the Vietnam National Children’s Hospital from October 2022 to April 2023.
Subjects and methods: Follow-up study Retrospective review of 312 children under 16 years old at the time of diagnosis of HIV infection and registration for ARV treatment at the National Children’s Hospital from January 1, 2006 to April 30, 2018.
Results: Mean age 15.8 ± 4.1 years. The male/female ratio is 1.36/1. When starting ART: 53.5% of children were in clinical stages 3 and 4. 69.6% (215/309) of children had TCD4 counts at the level of severe immunodefciency. At the time of the study: 93.9% (293/312) of children had normal TCD4 counts, 94.9% (296/312) of children had viral loads below 200 copies/mm3. During treatment: 19.9% (62/312) of children failed frst-line ARV, 4.2% (13/312) of children failed second-line ARV. 4.2% (13/312) of children had anemia or severe granulocytopenia when using Zidovudine. 6.4% (20/312) of children had drug allergies, of which 2.2% (7/312 children) had to change their medicine. 17.6% (55/312) of children had increased triglycerides. ARV drugs with the risk of increasing triglycerides were Lopinavir/ritonavir (OR = 22; [95%CI:10.524 – 46.114], p<0.0001) and Abacavir ( OR = 4.6; [95%CI:2.456 – 8.492], p<0.0001). 14.1% (44/312) of children had high cholesterol, ARV drugs with the risk of increasing cholesterol were Lopinavir/ritonavir (OR = 8; [95%CI:3.965 – 16.320], p<0.0001,) and Abacavir (OR = 7.1; [95%CI:3.457-14.628], p<0.0001). 7.7% (24/312) of children had an increase in GPT >40U/L and 6.4% (20/312) of children had an increase in GOT >40U/L. When using a regimen containing both TDF and EFV, there is a risk of increasing GPT (OR = 4.4; [95%CI: 1.114 - 17.601], p = 0.056), increasing GOT (OR = 5.5; [95% CI, 1.375 – 22.397], p=0.034).
Conclusion: Children infected with HIV start ARV treatment late, most children are severely immunocompromised and in clinical stages 3 and 4. About 1/4 of children on ARV treatment fail frst-line treatment. and some children fail second-line ARV treatment. Side effects of ARV drugs: increased liver enzymes GOT, GPT, increased triglycerides and cholesterol.
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Keywords
HIV, HIV treatment for children, HIV treatment, children, ARV treatment
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