Response to antiretroviral therapy in HIV-infected ugandan children exposed and not exposed to single-dose nevirapine at birth

Philippa M. Musoke, Linda Barlow-Mosha, Danstan Bagenda, Peter Mudiope, Michael Mubiru, Patrick Ajuna, James K. Tumwine, Mary Glenn Fowler

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

OBJECTIVE: To compare the response to a nevirapine (NVP)-based highly active antiretroviral therapy (HAART) in HIV-infected Ugandan children, exposed and nonexposed to single-dose NVP (sd NVP) at birth. METHODS: HIV-infected study children were initiated on stavudine/lamivudine/NVP as a fixed dose combination. CD4 cell percent and HIV-1 RNA were documented at baseline, 12, 24, 36, and 48 weeks post-initiation of HAART. RESULTS: Ninety-two children were enrolled in the study, 44 in the sd NVP-exposed and 48 in the nonexposed cohort. The median age at enrollment was 1.7 years [interquartile range (IQR) 1.2-2.4] and 7.8 years (IQR 5.9-9.2) in the sd NVP-exposed and nonexposed cohorts, respectively (P < 0.001). At baseline and week 48 post-HAART, the median CD4 cell percentages were 14% and 33% for the NVP-exposed group and 8% and 22.5% in the nonexposed group (P < 0.0001). The median (IQR) viral load at baseline was 650,568 (359,979-2,086,613) RNA copies/mL and 239,027 (105,904-494,813) RNA copies/mL in the NVP-exposed and nonexposed cohorts, respectively. After 48 weeks of HAART, 76% of the NVP-exposed and 80% of the nonexposed children had a median viral load of <400 copies/mL (P = 0.74). CONCLUSIONS: Both HIV-infected Ugandan older infants and children that were exposed and not exposed to sd NVP at birth had favorable treatment outcomes on NVP-containing HAART.

Original languageEnglish (US)
Pages (from-to)560-568
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes
Volume52
Issue number5
DOIs
StatePublished - Dec 1 2009

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Nevirapine
Highly Active Antiretroviral Therapy
HIV
Parturition
RNA
Viral Load
Therapeutics
HIV-1

Keywords

  • Antiretroviral treatment
  • Children
  • HIV
  • Nevirapine exposure

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Response to antiretroviral therapy in HIV-infected ugandan children exposed and not exposed to single-dose nevirapine at birth. / Musoke, Philippa M.; Barlow-Mosha, Linda; Bagenda, Danstan; Mudiope, Peter; Mubiru, Michael; Ajuna, Patrick; Tumwine, James K.; Fowler, Mary Glenn.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 52, No. 5, 01.12.2009, p. 560-568.

Research output: Contribution to journalArticle

Musoke, Philippa M. ; Barlow-Mosha, Linda ; Bagenda, Danstan ; Mudiope, Peter ; Mubiru, Michael ; Ajuna, Patrick ; Tumwine, James K. ; Fowler, Mary Glenn. / Response to antiretroviral therapy in HIV-infected ugandan children exposed and not exposed to single-dose nevirapine at birth. In: Journal of Acquired Immune Deficiency Syndromes. 2009 ; Vol. 52, No. 5. pp. 560-568.
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T1 - Response to antiretroviral therapy in HIV-infected ugandan children exposed and not exposed to single-dose nevirapine at birth

AU - Musoke, Philippa M.

AU - Barlow-Mosha, Linda

AU - Bagenda, Danstan

AU - Mudiope, Peter

AU - Mubiru, Michael

AU - Ajuna, Patrick

AU - Tumwine, James K.

AU - Fowler, Mary Glenn

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AB - OBJECTIVE: To compare the response to a nevirapine (NVP)-based highly active antiretroviral therapy (HAART) in HIV-infected Ugandan children, exposed and nonexposed to single-dose NVP (sd NVP) at birth. METHODS: HIV-infected study children were initiated on stavudine/lamivudine/NVP as a fixed dose combination. CD4 cell percent and HIV-1 RNA were documented at baseline, 12, 24, 36, and 48 weeks post-initiation of HAART. RESULTS: Ninety-two children were enrolled in the study, 44 in the sd NVP-exposed and 48 in the nonexposed cohort. The median age at enrollment was 1.7 years [interquartile range (IQR) 1.2-2.4] and 7.8 years (IQR 5.9-9.2) in the sd NVP-exposed and nonexposed cohorts, respectively (P < 0.001). At baseline and week 48 post-HAART, the median CD4 cell percentages were 14% and 33% for the NVP-exposed group and 8% and 22.5% in the nonexposed group (P < 0.0001). The median (IQR) viral load at baseline was 650,568 (359,979-2,086,613) RNA copies/mL and 239,027 (105,904-494,813) RNA copies/mL in the NVP-exposed and nonexposed cohorts, respectively. After 48 weeks of HAART, 76% of the NVP-exposed and 80% of the nonexposed children had a median viral load of <400 copies/mL (P = 0.74). CONCLUSIONS: Both HIV-infected Ugandan older infants and children that were exposed and not exposed to sd NVP at birth had favorable treatment outcomes on NVP-containing HAART.

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