Long-term observation of adolescents initiating HAART therapy: Three-year follow-up

Patricia M. Flynn, Bret J. Rudy, Jane C. Lindsey, Steven D. Douglas, Janet Lathey, Stephen A. Spector, Jaime Martinez, Margarita Silio, Marvin Belzer, Lawrence Friedman, Lawrence D'Angelo, Elizabeth Smith, Janice Hodge, Michael D. Hughes

Research output: Contribution to journalArticle

51 Scopus citations

Abstract

The PACTG 381 cohort included 120 adolescents infected via high-risk behaviors and treated with at least two NRTIs plus either a protease inhibitor or an efavirenz-containing HAART regimen. After 24 weeks of therapy, only 69 of 118 (59%) evaluable subjects had undetectable viral loads. We now present findings of the study after 3 years of follow-up. Virologic, immunologic, and treatment information were collected from subjects every 12 weeks beyond the first 24 weeks of therapy through 156 weeks. Of the 120 subjects starting HAART, 44 (37%) stayed on study treatment for the 3 years of observation. Twenty-nine (24%) subjects reached and maintained undetectable viral loads. Poorer adherence (p = 0.016), higher baseline viral load (p = 0.010), and CD8 naive counts (p = 0.034) predicted virologic failure. Immunologic measurements improved from entry to the end of follow-up in the subjects with undetectable viral loads. CD4 counts at the end of study were not significantly different from HIV-uninfected youth, but CD4%, CD8 counts and percent, and CD8 activation markers remained significantly different. Adolescents infected with HIV via high-risk behaviors have less than optimal responses to HAART therapy with only 24% achieving and maintaining undetectable viral loads over 3 years. Immunologic improvement was demonstrated and CD4 counts in subjects with virologic control reached levels in HIV-uninfected adolescents. Interventions, especially those focused on adherence, are necessary to improve HAART outcomes in adolescents.

Original languageEnglish (US)
Pages (from-to)1208-1214
Number of pages7
JournalAIDS research and human retroviruses
Volume23
Issue number10
DOIs
StatePublished - Oct 1 2007

ASJC Scopus subject areas

  • Immunology
  • Virology
  • Infectious Diseases

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    Flynn, P. M., Rudy, B. J., Lindsey, J. C., Douglas, S. D., Lathey, J., Spector, S. A., Martinez, J., Silio, M., Belzer, M., Friedman, L., D'Angelo, L., Smith, E., Hodge, J., & Hughes, M. D. (2007). Long-term observation of adolescents initiating HAART therapy: Three-year follow-up. AIDS research and human retroviruses, 23(10), 1208-1214. https://doi.org/10.1089/aid.2006.0290