CLINICAL-IMMUNOLOGICAL ASSESSMENT FAILURE ON INITIAL COMBINATION USE OF ZIDOVUDINE-LAMIVUDINE-NEVIRAPINE IN CHILDREN WITH HIV/AIDS AT SANGLAH HOSPITAL BALI
<p><strong>Background: </strong>Assessing clinical progression and CD4<sup>+</sup> level were important in determining the efficacy of antiretroviral (ARV) and switching to other regimens, especially when viral-load data were not available. <sup> </sup>Thi...
Main Authors: | , , , |
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Format: | Article |
Language: | English |
Published: |
DiscoverSys
2014-05-01
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Series: | Bali Medical Journal |
Subjects: | |
Online Access: | https://balimedicaljournal.org/index.php/bmj/article/view/77 |
Summary: | <p><strong>Background: </strong>Assessing clinical progression and CD4<sup>+</sup> level were important in determining the efficacy of antiretroviral (ARV) and switching to other regimens, especially when viral-load data were not available. <sup> </sup>This research aims to assess combination of zidovudine-lamivudine-nevirapine (Co-ZLN) failure using WHO 2010 criteria on clinical failure (CF) and immunological failure (IF), single or together, to determine correlation between CF and IF; and to evaluate two failure categories (CF alone and combination of CF-IF) in making decision to switch to second-line of ARV. <strong>Methods:</strong> Children at Sanglah General Hospital, who gain initial treatment of Co-ZLN in period of March 2006–March 2013 were selected. Cross-sectional study was applied. The ARV response was assessed twice. First period (P1) and second period (P2) of evaluation were conducted after patients received the Co-ZLN at least 6 and 12 months. <strong>Results:</strong> Forty five patients were included in this study. After at least 6 and 12 months of therapy, more patients showed IF (10 and 9 children in P1 and P2) than those in CF (4 and 2 patients in P1 and P2). Only one child met to CF-IF category in P2. The low clinical condition (HIV stage 4) did not always associate with deteriorating immunologic marker in the treatment-failure (TF). The patients who fit on CF and CF-IF based decision to switch regimen criteria were different. In resource-limited hospital, CF-IF based decision could give a better picture of patients’ condition and be used as an indicator to assess TF compared to single CF criteria.</p> |
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ISSN: | 2089-1180 2302-2914 |