Outcomes of infants starting Antiretroviral therapy in Southern Africa

Master Thesis

2014

Permanent link to this Item
http://hdl.handle.net/11427/13343
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thesis_hsf_2014_porter_m.pdf (2.27 MB)
Authors
Porter, Mireille
Supervisors
Davies, Mary-Ann
Eley, Brian
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University of Cape Town

Department
Department of Public Health and Family Medicine
Faculty
Faculty of Health Sciences
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Abstract
Within the global burden of the Human Immune Deficiency Virus (HIV) stands a distinct group - HIV infected infants. They are a physically, physiologically, developmentally and socially vulnerable group who differ considerably from their adult and child HIV infected counterparts. Distinguished in part by their multiple age-specific complexities in testing, treatment and monitoring these infants ultimately experience accelerated disease progression and an increased risk of morbidity and mortality. Advances in evidence gained from trials of the benefits of early initiation of ART in infants have resulted in international treatment guidelines changes and an increase in velocity and coverage of infant ART provision. However, there is limited published data on the outcomes of infants starting ART in routine care in Southern Africa. Objectives: To describe the baseline characteristics of infants starting first line ART in routine care setting in Southern Africa. To describe and examine the outcomes of these infants including clinical, immunological and virological responses and to identify the determinants for these outcomes. Method: A retrospective analysis was performed of prospectively collected cohort data of infants that initiated ART in routine care settings at the International Epidemiologic Databases to Evaluate AIDS in Southern Africa (IeDEA-SA) collaborative sites. A description of demographic, clinical, laboratory and program baseline characteristics is provided and longitudinal profiles of response variables are described. The Kaplan-Meier method was used to assess time to outcomes of mortality and virological outcome. Cox Proportional Hazards models identified those baseline characteristics associated with each of these outcomes. Competing Risk Analysis provides Cumulative Incidence Functions for mortality and programmatic outcomes. Multiple imputation was conducted and Rubin’s Rules provided pooled estimates from Survival Analysis.
Description

Includes bibliographical references.

Keywords
Public Health

Reference:

Porter, M. 2014. Outcomes of infants starting Antiretroviral therapy in Southern Africa. University of Cape Town.

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Masters