Data from theCollaborative HIV Paediatric

Study(CHIPS)

Reports up to May 2005

Background for CHIPS

The Collaborative HIV Paediatric Study (CHIPS) was established in April 2000 as a multi-centre cohort study of HIV infected children in the UK and Ireland.

The collaboration is between • 25 centres in the UK and Ireland that care for HIV-infected children, many of whom are enrolled in PENTA trials • the National Study of HIV in Pregnancy and Childhood (NSHPC), and •the MRC Clinical Trials Unit

794

24 26 1952 79

0

200

400

600

800

Still in CHI PS

follow- up

Transferred

to non- CHI PS

centres

Left country Lost to

follow- up

Transferred

to adult care

Died

Num

ber

of

childre

nFollow-up status of 994 children

enrolled in CHIPS

Age and year at first presentation to medical services in UK (N=994)

Up to 2002 2003 2004 2005

At birth 100(12%) 9( 8%) 3( 6%) 0

<1 yr 225(27%) 12(11%) 9(17%) 0

1-4 yrs 289(35%) 24(21%) 16(31%) 0

5-9 yrs 151(18%) 45(40%) 15(29%) 3

>=10 yrs 62( 8%) 22(20%) 9(17%) 0

Total 827 112 52 3

Year No in Median age -------------- Age groups -----------

follow-up (IQR) <1 yr 1-4 yrs 5-9 yrs 10 yrs

1996 336 4.3(2.0-6.7) 47(14%) 141(42%) 118(35%) 30(9%)

1997 384 4.7(2.1-7.4) 58(15%) 142(37%) 145(38%) 39(10%)

1998 456 5.0(2.5-8.1) 56(12%) 166(36%) 173(38%) 61(13%)

1999 514 5.8(2.9-8.9) 43(8%) 176(34%) 204(40%) 91(18%)

2000 584 6.3(3.3-9.6) 39(7%) 188(32%) 230(39%) 127(22%)

2001 651 7.1(3.9-10.4) 38(6%) 187(29%) 247(38%) 179(27%)

2002 718 7.5(4.4-10.9) 37(5%) 178(25%) 279(39%) 224(31%)

2003 802 8.0(5.1-11.3) 37(5%) 160(20%) 328(41%) 277(35%)

2004 800 8.5(5.7-11.9) 29(4%) 139(17%) 315(39%) 317(40%)

Age distribution of children in follow-up over calendar time

* Age is taken to be age at start of the year, or age at presentation if child presented during that year

All hospital admissions during 2000-2003

Year Number Number Proportion Total Rate

children children admitted number (# adm per

seen admitted (%) admissions pyar)

2000 584 163 28 324 0.60

2001 651 170 26 299 0.50

2002 718 145 20 231 0.35

2003 802 161 20 280 0.39

Admissions may be underreported for children in shared care where only information from the main CHIPS follow-up centre are reported. Data for 2004 are incomplete and are not presented.

HIV RNA viral load at 6 months after starting HAART as first line

therapyN=434 with measurements available (96 missing)

Year HIV RNA (copies/ml)

<50 51-<400 >400

-1999 32 (20%) 58 (36%) 70 (44%)

2000/02 47 (30%) 59 (37%) 52 (33%)

2003- 69 (59%) 25 (22%) 22 (19%)

Total 148 (34%) 142 (33%) 144 (33%)

Data on 818 children who are still alive and in follow-up (794 in CHIPS centres and

24 who have transferred to non-CHIPS centres)

Those who have died, lost to follow-up, left the UK & Ireland or transferred to adult care are excluded

Demographic Data (N=818)

* Data provided by NSHPC

- 418(51%) are female

- 450(55%) born UK/Ireland, 366(45%) born abroad (2 missing)

- Ethnicity White 87 (11%) Black African 611 (75%) Black Other 12 (1%) Indian SC 11 (1%) Mixed 84 (10%) Other 7 (1%) Not known 6 (1%)

- Diagnosis of maternal infection (N=777 vertically infected) Known after delivery 650 (84%) Known before delivery 111 (14%) Not known 16 (2%)

636 (78%)London

18 (2%) Scotland

98 (12%)Rest of England

58 (8%)Ireland

8 (1%)Wales

Regional distribution ofmain follow-up centre for

818 children alive and followed up in CHIPS

Children who have died, lost to follow-up, left the UK & Ireland or transferred to adult care are excluded

Year of last follow-up (N=818)

16 28

488

286

0

100

200

300

400

500

600

2002 2003 J an- J une

2004

Since J uly

2004

Num

ber

of

child

ren

Clinical stage by age at last follow-up (N=818)

0%

20%

40%

60%

<2 2-4 years 5-9 years >10 years

% o

f ch

ildre

n

Stage N/ A

Stage B

Stage C

Number of children: Total (col %)

18 51 143 134 346 (42%)

2 16 84 136 238 (29%)

16 30 91 97 234 (29%)

Antiretroviral drug experience N=802 children with follow-up since January 2003

0%

20%

40%

60%

80%

<2 years 2-4 years 5-9 years >10 years

% o

f ch

ildre

n

Naïve

1-4 drugs

5-7 drugs

>=8 drugs

Number of children: Total (col %)

7 27 83 75 192 (24%)

25 51 143 125 344 (43%)

2 14 67 101 184 (23%)

0 1 22 59 82 (10%)

ART at last follow-upN=526 children with follow-up since Jan 2003 were on treatment

7 on dual, 449 on 3-drug, 67 on 4-drug and 3 on 5(+)-drug therapy

18

196

268

41

2 10

50

100

150

200

250

300

PI+NNRTI PI+.. NNRTI+.. 3 NRTI 4 NRTI 2 NRTI

Num

ber

of c

hild

ren

0

20

40

60

80

100

120

140N

umbe

r of

chi

ldre

n

Naïve 7 51 87 44

On dual 1 2 3 1

On initial HAART 5 63 107 137

On subseq HAART 12 49 74 68

Off ART 5 20 39 19

- 10% - 20% - 30% >30%

Most recent CD4% (N=794)Children followed up since January 2003

020406080

100120140160180

Num

ber

of c

hild

ren

Naïve 2 8 154 24

On dual 1 3 2 1

On initial HAART 168 77 63 4

On subseq HAART 87 61 52 3

Off ART 1 4 65 13

<50 copies/ml 51- <400 401- 100000 >100000

Most recent HIV RNA viral load (N=793)

Children followed up since January 2003