Trend of Antiretroviral therapy interruption in a clinic cohort of HIV-infected children in Jos, Nigeria

Abstract

Background: In the early years of introducing antiretroviral therapy (ART), compromised adherence to ART in children, from treatment interruptions, was a challenge partly due to lack of trained or experienced personnel with expertise in adherence counselling. Over subsequent years with increasing expertise coupled with more patient education and public awareness it is expected that these interruptions would decline. We therefore determined the trend in ART interruptions in a clinic cohort of HIV-1 infected children attending the Jos University Teaching Hospital (JUTH).
Methods: This was a retrospective analysis of data on 580 children, aged 2 months – 15 years, who were enrolled on ART between February 2006 and December 2010 at JUTH. Children who had ART interruptions were compared with those who did not. The odds of ART interruption versus no ART interruption, across the categories of year enrolled on ART were examined using the test of homogeneity of odds. The trend in ART interruptions over a period of 5 years was examined using score test for trend of odds.
Results: The overall frequency of ART interruptions per child among the 580 study subjects over a period of 5 years was 20.2%, that is, 4.04% per year. The odds of ART interruptions was different across the years from 2006 to 2010 (p= <0.0001). There was also evidence for a trend in the decreasing odds of ART interruptions over the years (p= <0.0001).
Conclusion: ART interruptions declined over the years in children attending the HIV clinic and this may have been due to enhanced ART adherence as a result of repeated health education and decreasing HIV stigmatization.

Keywords: Antiretroviral therapy interruptions, Trend, HIV- 1, Adherence, Health education