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Apr 22, 2016Article Details
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Main Article Content
Initial experience of a public sector antiretroviral treat:ment programme for HIV-infected children and their infected parents
Abstract
Design. Prospective, cohort study.
Setting. Tertiary, referral hospital.
Patients. HIV-infected children and their parents.
Methods. This report focuses on the early response of children to highly active antiretroviral therapy (HAART). Children were followed up at 4-weekly intervals. Monitoring included initial and yearly viral load measurements, baseline and 6- monthly CD4 counts and 4-weekly adherence checks.
Results. Between August 2002 and June 2003, 80 children were enrolled in the programme, representing a follow-up period of 23.9 patient-years. Seventy-five children had severe clinical disease, severe immune suppression, or a combination of the two. The response of children who had received HAART for ;, 6 months (N = 17) was assessed. There was no change in mass z-score (p = 0.11) or length z-score (p = 0.37), but a significant increase in CD4 percentage (p < 0.0001) during the first 6 months of therapy. Six-month viral loads were available for 12 children. There was a significant drop in viral load (p = 0.001) and 9 achieved undetectable levels by 6 months. Most children achieved "'= 85% adherence. By June 2002, 67 children (84%) were relatively well, 1 had 8-celllymphoma, 7 (8.8%) had died, 4 (5%) were lost to follow-up and 1 was withdrawn from the programme. Of 57 children who completed 3 months of HAART, 12 were admitted a total of 17 times for infectious complications. There were no severe drug reactions. Three of 7 mothers on HAART received treatment through the programme.
Conclusion. These initial results suggest that many HIVinfected children in the public sector will benefit from . antiretroviral therapy. However, both ambulatory and inpatient facilities are required to manage children on HAART comprehensively.
