Objective To understand the effects of antiviral therapy in children with AIDS in Nanyang, Henan province, and provide evidence for the standard treatment and management of AIDS in children.
Methods A retrospective cohort study method was used to conduct a descriptive analysis on the main epidemiological characteristics, treatments, laboratory tests, and deaths of child AIDS cases included in the AIDS comprehensive prevention and treatment information system in Nanyang from 2011 to 2019 and evaluate the effects of antiviral therapy.
Results In 112 child AIDS cases, 26 were fatal. The median of time from the beginning of the treatment to the observation end was 4.83 (1.67 to 6.86) years. The average age of cases at the beginning of treatment was (7.12±3.54) years. The CD4＋T lymphocyte count of 1 year, 3 years and 5 years after treatment were significantly higher than the treatment baseline, the difference was significant (P<0.01), but the CD4 count showed a downward trend after more than 5 years of treatment, and there was no significant difference compared with the baseline (P>0.05). The viral load suppression ratios were 90.53%, 90.80%, 84.15%, 75.95%, and 67.50% in the 1st, 3rd, 5th, 7th, and 9th years after treatment, respectively, showing a downward trend, and the difference in viral load suppression ratio was significant between the 7th or 9th years and the 1st year (P<0.05). The causes of the deaths were as follows: AIDS-related disease (21 cases, 80.77%), and accidental death (5 cases, 19.23%). The average interval between diagnosis and death was (2.68 ± 2.46) years, and the death rate within 1 year of treatment was 46.75/100 person year.
Conclusion Late diagnosis of AIDS in children was a prominent problem in Nanyang, and the mortality in the early stage of treatment was high. After more than 5 years of antiviral therapy, the virological and immunological effects had downward trends. Measures should be taken for the early detection and early treatment of HIV/AIDS in children.
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