Long-term outcome in fully treated HIV-infected children in West Java-Indonesia: Gender differences

Abstract

Introduction: Since the discovery of highly active anti-retroviral therapy (HAART), there is an improvement in virology findings, thus human immunodeficiency virus type 1 (HIV-1)-infected children can grow and thrive properly. Studies have showed successful treatments of HIV-1-infected children in limited resources are differed by gender. Material and methods: We enrolled children 2 - < 15 years old, vertically transmitted, with good treatment adherence and condition, and minimal therapy duration of 6 months. The study has been approved by the Research and Ethics Committee. Results: One hundred and sixty-eight children were enrolled, 99 were excluded because of lack of adherence and loss to follow-up. As many as 70 children have met the inclusion criteria, 40 (57.1%) children were females, who started anti-retroviral therapy (ART) therapy at the median age of 8 (range, 2.0-14.0 years). When the therapy started, 45 (64.3%) children were moderately to severely symptomatic (WHO stage 3 or 4), and most of them were males. Meanwhile, boys had higher improvement outcome of CD4 with median 10.5% (r = 3-45.7; p = 0.030) and lower viral loads than girls, although all HIV viruses were detected below 20 copy/ml. There was no significant relevance between caregiver and the treatment success. Conclusions: Children in limited resources, especially boys, can achieve successful therapeutic outcome with good treatment adherence and taking medication regardless of the caregiver.