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

• Published in: Healthcare (Basel) Vol. 10; no. 11; p. 2156
• Main Authors: Lain, Maria Grazia, Vaz, Paula, Sanna, Marco, Ismael, Nalia, Chicumbe, Sérgio, Simione, Teresa Beatriz, Cantarutti, Anna, Porcu, Gloria, Rinaldi, Stefano, de Armas, Lesley, Dinh, Vinh, Pallikkuth, Suresh, Pahwa, Rajendra, Palma, Paolo, Cotugno, Nicola, Pahwa, Savita
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 28-10-2022; MDPI
• Subjects: Acquired immune deficiency syndrome; adherence; Age; AIDS; Antiretroviral drugs; Antiviral agents; Caregivers; Dosage and administration; Drug resistance; early antiretroviral therapy; Health aspects; HIV; HIV infection in children; Human immunodeficiency virus; Infant health services; Measurement; Mutation; pediatric HIV; Pediatrics; Plasma; Prevention; Psychological aspects; Risk factors; Social networks; Statistical analysis; viral load suppression; viral rebound; Viremia; Mozambique; viral load suppression; early antiretroviral therapy; drug resistance; adherence; pediatric HIV; viral rebound
• ISSN: 2227-9032; 2227-9032
• DOI: 10.3390/healthcare10112156

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.