Context: Antiretroviral therapy (ART) for pediatric human immunodeficiency vir us (HIV) infection has evolved from simple nucleoside reverse transcriptase inhi bitor (NRTI)-regimens to complex combination therapies based largely on evidenc e from clinical trials. However, the integration of novel ART into the clinical care of pediatric HIV infection has not been examined. Objectives: To describe c hanges in the treatment of pediatric HIV infection in the United States from 198 7-2003, to assess concordance of initial regimens with US pediatric guidelines, and to identify predictors of the first regimen switch. Design, Setting, and Pa rticipants: The study population included 766 perinatally HIV-infected children in the Pediatric AIDS Clinical Trials Group 219C cohort born before January 1, 2004, who had not participated in an ART clinical trial at 219C enrollment or du ring follow-up. Main Outcome Measures: Proportion of children receiving specifi c ART regimens, proportion of children initiating ART according to pediatric gui delines, and time to first regimen switch (risk of switching). Results Single an d dual NRTI regimens were used most frequently through 1997. In 1998, 2 years af ter protease inhibitors were approved for adult HIV infection and at the time pe diatric guidelines were issued, regimens of highly active antiretroviral therapy including a protease inhibitor became most frequently used. From 1998-2003, 22 %of children initiated ART with a regimen not recommended by pediatric guidelines. In multivariate regression, the risk of switching decreased with age at ART ini tiation (hazard ratio [HR], 0.96; 95%confidence interval [CI], 0.94-0.99) and increased with year of initiation (HR, 1.28; 95%CI, 1.23-1.33). The risk of sw itching was higher in children who started with 1 NRTI (HR, 8.05; 95%CI, 5.80- 11.18), 2 NRTIs (HR, 4.08; 95%CI, 3.08-5.40), or an unconventional regimen (HR , 6.23; 95%CI, 3.36-11.54) vs children who started with a protease inhibitor- containing regimen; and in children who initia
在非洲,结核是与人类免疫缺陷病毒(HIV)感染有关的常见严重疾病之一。对卢旺达和其他结核病高发国家中的婴儿,世界卫生组织(WHO)建议在出生时接种卡介苗(BCG)。本文报道了在基加利(卢旺达首都)进行研究的总结,该项研究观察了血 HIV 阳性和阴性母亲所生婴儿,接种卡介苗后免疫反应和副作用的发生情况。那里育龄妇女艾滋病病毒感染率高达30%。1988年11月,在基加利开始了一项关于母亲 HIV-1传播给婴儿的前瞻性研究。截止1989年6月,该项研究登记了422名出生后第一周内注射了冻干 BCG
