Resumo

SICILIANO SABATELA, Luigina et al. Benefits of highly active antiretroviral therapy in pediatric patients with hiv infection. Arch Venez Puer Ped [online]. 2011, vol.74, n.3, pp.105-111. ISSN 0004-0649.

Background. Highly active antiretroviral therapy in HIV-infected patients minimizes viral replication, restores immune status and thus decreases morbidity and mortality. Objective. Determine hospitalization and mortality frequency in pediatric patients with HIV infection according to the type of antiretroviral treatment. Method. It was performed a clinical and retrospective study which included pediatric patients with HIV infection, attended at Hospital de Niños "J.M. de los Rios (Caracas, Venezuela) between 1993-2009. The recorded data were: year at first assessment, mechanism of viral transmission, immunological and virological status, antiretroviral treatment, need for hospitalization and death. Statistical analysis included Chi square. Results. 234 patients were evaluated: 73.1% (n=171) of vertical transmission and 26.9% (n=63) horizontal. Hospitalization and mortality decreased since 2000, when there was greater access to highly active antiretroviral therapy. Of all patients, 50.9% required hospitalization and 30.3% died. At first evaluation, there was immunosupression in 67.6% of those patients who required hospitalization and 43.3% who did not (p <0.05). Equally there was immunosupression in 75,8% of patients who died and 47% of the survivors at the end of the study (p<0,05). In hospitalized patients, most received no highly active antiretroviral therapy (74.6%) and had immunosupression (82.2%) with detectable viral load (96.4%). These findings were also seen in most patients who died: no highly active antiretroviral therapy (92.9%), immunosupression (95.1%) and detectable viral load (100%). Conclusions. Availability of highly active antiretroviral therapy decreases hospitalization and mortality. At first assessment, patients with immunosupression had higher complication rates. At the time of hospitalization or death, most patients did not receive highly effective antiretroviral therapy and had immunosupression with detectable viral load.

Palavras-chave : HIV infection; pediatric; highly active antiretroviral therapy; hospitalization; mortality.