Initial experience of a public sector antiretroviral treatment programme for HIV-infected children and their infected parents
| dc.contributor.author | Eley, Brian | |
| dc.contributor.author | Nuttall, James | |
| dc.contributor.author | Davies, Mary-Ann | |
| dc.contributor.author | Smith, Lara | |
| dc.contributor.author | Cowburn, Carol | |
| dc.contributor.author | Buys, Heloise | |
| dc.contributor.author | Hussey, Gregory | |
| dc.date.accessioned | 2018-09-12T10:26:13Z | |
| dc.date.available | 2018-09-12T10:26:13Z | |
| dc.date.issued | 2004 | |
| dc.date.updated | 2016-01-18T07:55:25Z | |
| dc.description.abstract | Objective. To describe the initial experience of treating HIVinfected children and their infected parents with antiretroviral therapy. 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children (84%) were relatively well, 1 had B-cell lymphoma, 7 (8.8%) had died, 4 (5%) were lost to follow-up and 1 was withdrawn from the programme.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 | |
| dc.identifier.apacitation | Eley, B., Nuttall, J., Davies, M., Smith, L., Cowburn, C., Buys, H., & Hussey, G. (2004). Initial experience of a public sector antiretroviral treatment programme for HIV-infected children and their infected parents. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/28471 | en_ZA |
| dc.identifier.chicagocitation | Eley, Brian, James Nuttall, Mary-Ann Davies, Lara Smith, Carol Cowburn, Heloise Buys, and Gregory Hussey "Initial experience of a public sector antiretroviral treatment programme for HIV-infected children and their infected parents." <i>South African Medical Journal</i> (2004) http://hdl.handle.net/11427/28471 | en_ZA |
| dc.identifier.citation | Eley, B., Nuttall, J., Davies, M. A., Smith, L., Cowburn, C., Buys, H., & Hussey, G. (2004). Initial experience of a public sector antiretroviral treatment programme for HIV-infected children and their infected parents: original article. South African medical journal, 94(8), p-643. | |
| dc.identifier.ris | TY - AU - Eley, Brian AU - Nuttall, James AU - Davies, Mary-Ann AU - Smith, Lara AU - Cowburn, Carol AU - Buys, Heloise AU - Hussey, Gregory AB - Objective. To describe the initial experience of treating HIVinfected children and their infected parents with antiretroviral therapy. 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 B-cell lymphoma, 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 DA - 2004 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2004 T1 - Initial experience of a public sector antiretroviral treatment programme for HIV-infected children and their infected parents TI - Initial experience of a public sector antiretroviral treatment programme for HIV-infected children and their infected parents UR - http://hdl.handle.net/11427/28471 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/28471 | |
| dc.identifier.vancouvercitation | Eley B, Nuttall J, Davies M, Smith L, Cowburn C, Buys H, et al. Initial experience of a public sector antiretroviral treatment programme for HIV-infected children and their infected parents. South African Medical Journal. 2004; http://hdl.handle.net/11427/28471. | en_ZA |
| dc.language.iso | eng | |
| dc.publisher.department | Department of Paediatrics and Child Health | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.source | South African Medical Journal | |
| dc.source.uri | http://www.samj.org.za | |
| dc.title | Initial experience of a public sector antiretroviral treatment programme for HIV-infected children and their infected parents | |
| dc.type | Journal Article | |
| uct.type.filetype | Text | |
| uct.type.filetype | Image |