ESPID Education. Santos-Sebastián M. Jun 7, 2011; 7792
Ms. Mar Santos-Sebastián
Ms. Mar Santos-Sebastián

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M. Santos-Sebastián, ML Navarro-Gómez, S Jimenez de Ory, J Saavedra-Lozano, MI de José-Gomez , MI Gonzalez-Tomé; MJ Mellado Peña, P Rojo-Conejo, MD Gurbindo, J Beceiro, D Blázquez, S. Guillén , MA Muñoz_Fernández, JT Ramos Amador, on behalf of the Madrid Cohort of HIV-infected children and adolescents.

Background and aims: HAART has improved survival in HIV infected patient, but may be associated with important adverse events. Simplification of HAART may improve adherence and metabolic alterations. The aim was to describe virologic, inmunologic, clinical and lipid profile outcome in HIV-infected children after simplification.

Methods: Prospective, multicenter study of children of the 310 HIV-infected children and adolescents in the Madrid Cohort since 2003. Fifty-six simplifications were studied in 44 patients. The simplified regimens included protease inhibitor withdrawal(type 1), decrease in pill number(type 2), change from BID to QD treatment(type 3), change from one nucleoside-analog to another with less toxicity (type 4) and use of a “combo” with FTC+ABC+EFV(type 5).

Results: Median age at the time of simplification was 13.6(10.6-16.6) years, 18 (40.9%) were clinical category C and 11(25%) category B. In 13 patients (23.6%) simplification was type 1, 33(60%) type 2, 24(43.6%) type 3, 24(43.6%) type 4 and 18(32.1%) type 5.
No patients experienced severe clinical events. Two patients developed an increase in viral load. The median baseline CD 4% was 33.8%(SD 6.3), and increased at 6(34.9%; p=0.021), 12(36.3%; p=0.005), 18(35.2%; p=0.050) and 24 months (34.8% p=0,074).
Median baseline lipids were: cholesterol 186(SD 44.6), triglycerides 157(SD 106). And decreased at 6(160 cholesterol; p<0,01, 128 triglycerides; p=0.014), 12(163 cholesterol; p=0.06, 108 triglycerides; p=0.04), 18(168 cholesterol; p=0,36, 116 triglycerides; p=0,3) and 24 months (163 cholesterol; p=0.021, 105 triglycerides 0.093).

In our cohort simplification was safe and well tolerated. Furthemore, the immunological function and lipid profile of these children improved.
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