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