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《Journal of Applied Clinical Pediatrics》 2009-10
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Study on Short-Term Adverse Effects of Highly Activity Antiretroviral Therapy in Children with Acquired Immunodeficiency Syndrome

LI Zai-cun1,ZHAO Yan2,DOU Zhi-hui2,YU Lan2,HUANG Xiao-jie1,LI Hai-ying1,WU Hao1,ZHANG Fu-jie2,3 (1.Clinical Center for Sexually Transmitted Disease/Acquired Immunodeficiency Syndrome,Capital Medical University Beijing Youan Hospital,Beijing 100069,China;2.National Center for Sexually Transmited Disease/Acquired Immune Deficiency Syndrome Prevention and Control,China Center for Disease Prevention and Control,Beijing 100050,China;3.Department of Infection,Beijing Ditan Hospital,Beijing 100011,China)  
Objective To study on short-term adverse effects of highly activity antiretroviral therapy(HAART) in children infected with human immunodeficiency virus(HIV)-1 or acquired immune deficiency syndrome(AIDS).Methods Seventy-one children with HIV/AIDS,including 49 male and 22 female,aged 9.2 years old (ranged 2 to 16 years) were included in this prospective observational study.Forty-five cases received zidovudine(AZT) plus lamivudine(3TC) plus nevirapine(NVP) and 26 cases received stavudine(d4T) plus 3TC plus NVP.The adverse effects including gastrointestinal diaturbances,neutropenia,hemoglobin declining,transaminase elevation,rash,serum amyalse elevation) observed within 6 months after the initiation of therapy were compared between 2 regimens.Results The major adverse effects including gastrointestinal disturbance including nausea,vomit,diarrhea,stomachache,hemoglobin decline,neutrophil decline,elevated alanine transaminase elevation(ALT),rash,serum amylase elevation were seen in 52 cases (73.2%),30 cases (42.3%),12 cases (16.9%),15 cases (21.1%),10 cases (10.4%) and 6 cases (8.5%),respectively.No differences in adverse effects incidence were observed between AZT-containing and d4T-containing regimens,except in hemoglobin decline which was much common in zidovudine(AZT)-containing regimen compared with d4T-containnig regimen (56.5% vs 16.0% P=0.001).Six cases changed regimens,3 cases changed to stavudine(d4T) due to AZT-related anemia,1 case changed to efaviren(EFV) due to NVP-related rash and 2 cases changed to EFV due to ALT e-levation.No one discontinuated HAART because of the adverse effects.Conclusions The adverse effects are mild or moderate and well tollerated in children with HIV/AIDS receiving either AZT plus 3TC plus NVP or d4T plus 3TC plus NVP.Bone marrow suppression is more common in AZT-containing regimen compared with d4T-containing regimen.
【Fund】: 国家高技术研究发展计划项目资助(2006AA02Z411);; 北京市科委艾滋病重大项目资助(D0906003040591);; 首都医学发展科研基金项目资助(2005-2033)
【CateGory Index】: R725.1
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1 GUO Hong-mei1,2,WANG Jian-she1(1. Laboratory of Infectious Diseases,Children′s Hospital Affiliated to Fudan University,Shanghai 201102,China;2. Department of Digestive,Nanjing Children′s Hospital Affiliated to Nanjing Medical University,Nanjing 210008,Jiangshu Province,China);Guideline of Diagnosis and Treatment for Human Immunodeficiency Viruses Infection in Infants and Children in Resource-Limited Settings[J];Journal of Applied Clinical Pediatrics;2008-22
【Secondary Citations】
Chinese Journal Full-text Database 1 Hits
1 ZHAO Yan,GUO Wan-shen1,JIA Man-hong2,QIAO Xiao-chun3,LIU Wei4,YAO Xuan5,LI Chuan-tao6,DOU Zhi-hui,LI Zai-cun7,WANG Ning,ZHANG Fu-jie #(Division of Treatment and Care,National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention,Beijing 100050,China)1.Department of AIDS,Henan Center for Disease Control and Prevention,Zhengzhou 450003;2.Department of AIDS,Yunnan Center for Disease Control and Prevention,Kunming 650022;3.Department of AIDS,Shanxi Center for Disease Control and Prevention,Taiyuan 030012;4.Department of AIDS,Guangxi Center for Disease Control and Prevention,Nanning530021;5.Departmentof AIDS,Hubei Center for Disease Control and Prevention,Wuhan 430079;6.Department of AIDS,Lixin Center for Disease Control and Prevention,Lixin236700;7.Department of Infectious Diseases,Beijing Youan Hospital,Beijing100054;;Epidemiology of Pediatric HIV Infection in Six Provinces of China[J];Acta Academiae Medicinae Sinicae;2006-05
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