Background: The number of HIV infected children receiving antiviral treatment in Guangxi is increasing. Understanding factors and trends of mortality and attrition in HIV-infected children under antiretroviral therapy (ART) was an urgent need to improve treatment outcomes. This study aimed to estimate mortality and attrition rates and identify factors that were associated with mortality and attrition after ART initiation among children with HIV in Guangxi, China between 2004 and 2018.
Methods: Cohort study data were extracted from the National Free Antiretroviral Treatment Program (NFATP) database, which has standard guidelines for core treatment indicators and other data at all HIV/AIDS treatment facilities in Guangxi. A total of 901 HIV-infected children who have started ART were included in the study. The study collected the following data: age, gender, WHO clinic stages before ART, CD4 cell count before ART, Cotrimoxazole prophylaxis (CTX) use before ART, initial ART regimen, malnutrition before ART, abnormal liver function before ART, abnormal kidney function before ART, severe anemia before ART, and the time lag between an HIV diagnosis and ART initiation.
Results: HIV-infected children under ART had a mortality rate of 0.87 per 100 person-years [95% Confidence Interval (CI) 0.63-1.11], and an attrition rate of 3.02 per 100 person-years (95% CI 2.57-3.47). Mortality was lower among children with a CD4 count between 200 and 500 copies/ml [Adjusted Hazard Ratio (AHR) 0.22, 95% CI 0.09-0.55], and CD4 count ≥500 copies/ml (AHR 0.10, 95% CI 0.03-0.29); but higher among children with late ART initiation at 1-3 months (AHR 2.30, 95% CI 1.07-4.94), and at ≥3 months (AHR 2.22, 95% CI 1.04-4.74). Attrition was lower among children with a CD4 count ≥500 copies/ml (AHR 0.62, 95% CI 0.41-0.95), but higher among children with late ART initiation at 1-3 months (AHR 1.55, 95% CI 1.05-2.30).
Conclusion: Supportive programs are needed to educate children's families and parents on early ART, link HIV-infected children to care and retain them in care among other programs that treat and manage the medical conditions of HIV-infected children before ART initiation.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9315248 | PMC |
| http://dx.doi.org/10.3389/fped.2022.916740 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Ocular and Adnexal Diseases in Human Immunodeficiency Virus-Infected Pregnant Women Attending HIV Clinics in Ibadan, Nigeria.
J West Afr Coll Surg
October 2024
Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria.
Background: Human immunodeficiency virus (HIV) is a lentivirus. It is transmitted through sexual intercourse, shared intravenous drugs, contaminated needle use, blood transfusion, and mother-to-child transmission. Of the patients with HIV, 50%-75% have ocular manifestations and this may be the primary presentation.
View Article and Find Full Text PDFOnset and predictors of first-line antiretroviral therapy treatment failure among children in Ethiopia: a systematic review and meta-analysis.
BMC Pediatr
December 2024
Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Introduction: The emergence of First-line Antiretroviral Therapy (ART) regimens fails; it necessitates the use of more costly and less tolerable second-line medications. Therefore, it is crucial to identify and address factors that increase the likelihood of first-line ART regimen failure in children. Although numerous primary studies have examined the incidence of first-line ART failure among HIV-infected children in Ethiopia, national-level data on the onset and predictors remain inconsistent.
View Article and Find Full Text PDFDevelopmental delay and associated factors among HIV-infected under-five children in public health facilities, Southern Ethiopia.
Sci Rep
December 2024
School of Health and Medical Science, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia.
Delays in development that occur during early childhood can have long-lasting consequences, potentially leading to poor academic achievement. Research has shown that the human immunodeficiency virus can have neurotropic effects, which may impact the development of the brain in infected children. However, there is a scarcity of evidence regarding developmental delays among children with human immunodeficiency virus in the study area.
View Article and Find Full Text PDFMethods for measuring body composition in Zambian adolescents living with HIV.
PLOS Glob Public Health
December 2024
Institute of Child Health, University College London, London, United Kingdom.
Assessment of body composition can be useful in managing many clinical or public health conditions, including HIV. Most people living with HIV infection are in Africa where clinics may lack equipment, utilities or staff time for optimal body composition assessment. Thus, it is important to determine whether less expensive and more available and scalable methods can provide adequate information.
View Article and Find Full Text PDFAssociation between Childhood Trauma, Mental Health Symptoms and Adherence Among Youth Living with HIV in Botswana.
J Child Adolesc Trauma
December 2024
School of Nursing, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana.
Background: People living with HIV experience traumatic incidents at higher rates than the general population; and research has documented significant association between trauma exposure and the development of mental disorders. Mental health problems have a a negative impact on anti-retroviral treatment adherence. All of these psychosocial concerns play a role in potentially increasing HIV transmission to sexual partners resulting in increased incidence rates.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!