Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 28;10(11):2156.
doi: 10.3390/healthcare10112156.

Viral Response among Early Treated HIV Perinatally Infected Infants: Description of a Cohort in Southern Mozambique

Maria Grazia Lain  1 , Paula Vaz  1 , Marco Sanna  2 , Nalia Ismael  3 , Sérgio Chicumbe  4 , Teresa Beatriz Simione  5 , Anna Cantarutti  6 , Gloria Porcu  6 , Stefano Rinaldi  7 , Lesley de Armas  7 , Vinh Dinh  7 , Suresh Pallikkuth  7 , Rajendra Pahwa  7 , Paolo Palma  2   8 , Nicola Cotugno  2   8 , Savita Pahwa  7
Affiliations

Viral Response among Early Treated HIV Perinatally Infected Infants: Description of a Cohort in Southern Mozambique

Maria Grazia Lain et al. Healthcare (Basel). .

Abstract

Early initiation of antiretroviral therapy and adherence to achieve viral load suppression (VLS) are crucial for reducing morbidity and mortality of perinatally HIV-infected infants. In this descriptive cohort study of 39 HIV perinatally infected infants, who started treatment at one month of life in Mozambique, we aimed to describe the viral response over 2 years of follow up. VLS ≤ 400 copies/mL, sustained VLS and viral rebound were described using a Kaplan-Meier estimator. Antiretroviral drug transmitted resistance was assessed for a sub-group of non-VLS infants. In total, 61% of infants reached VLS, and 50% had a rebound. Cumulative probability of VLS was 36%, 51%, and 69% at 6, 12 and 24 months of treatment, respectively. The median duration of VLS was 7.4 months (IQR 12.6) and the cumulative probability of rebound at 6 months was 30%. Two infants had resistance biomarkers to drugs included in their treatment regimen. Our findings point to a low rate of VLS and high rate of viral rebound. More frequent viral response monitoring is advisable to identify infants with rebound and offer timely adherence support. It is urgent to tailor the psychosocial support model of care to this specific age group and offer differentiated service delivery to mother-baby pairs.

Keywords: adherence; drug resistance; early antiretroviral therapy; pediatric HIV; viral load suppression; viral rebound.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Cumulative probability of viral suppression (VL ≤ 400 copies/mL) among all infants. Note. The area in blue represents the 95% CI.
Figure 2
Figure 2
Cumulative probability of viral suppression (VL ≤ 400 copies/mL) among all infants who started ART according to pre-ART viral load. Note. The areas in blue and in orange represent the 95% CI.
Figure 3
Figure 3
Cumulative probability of viral rebound (VL > 1000 cp/mL) among infants who reached viral suppression (VL ≤ 400 copies/mL). Note. The area in blue represents the 95% CI.
Figure 4
Figure 4
Cumulative probability of re-suppression (VL ≤ 400 copies/mL) among infants who had viral rebound > 1000 copies/mL). Note. The area in blue represents the 95% CI.
Figure 5
Figure 5
Types and prevalence of pre-ART drug resistance mutations in infants who never reached viral suppression. Note. NRTI: nucleoside reverse transcriptase inhibitor; NNRTI: non-nucleoside reverse transcriptase inhibitor; PI: protease inhibitors.
See this image and copyright information in PMC

References

    1. UNAIDS . Countdown to Zero: Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive, 2011–2015. UNAIDS; Geneva, Switzerland: 2011.
    1. UNAIDS Start Free Stay Free AIDS Free—2019 report [Internet] 2019. [(accessed on 17 September 2019)]. Available online: https://www.unaids.org/en/resources/documents/2019/20190722_UNAIDS_SFSFA....
    1. UNAIDS Data 2021 [Internet] [(accessed on 5 June 2022)]. Available online: https://www.unaids.org/en/resources/documents/2021/2021_unaids_data.
    1. Bianchi F., Cohn J., Sacks E., Bailey R., Lemaire J.-F., Machekano R., Nzima V.N., Ekouévi P.F., Makone M., Odhiambo C.O., et al. Evaluation of a routine point-of-care intervention for early infant diagnosis of HIV: An observational study in eight African countries. Lancet HIV. 2019;6:e373–e381. doi: 10.1016/S2352-3018(19)30033-5. - DOI - PubMed
    1. Jani I.V., Meggi B., Loquiha O., Tobaiwa O., Mudenyanga C., Zitha A., Dadirayi M., Nedio M., Adolfo V., Timothy B., et al. Effect of point-of-care early infant diagnosis on antiretroviral therapy initiation and retention of patients. AIDS. 2018;32:1453. doi: 10.1097/QAD.0000000000001846. - DOI - PubMed

LinkOut - more resources