Outcomes of infants starting Antiretroviral therapy in Southern Africa

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dc.contributor.advisorDavies, Mary-Annen_ZA
dc.contributor.advisorEley, Brianen_ZA
dc.contributor.authorPorter, Mireilleen_ZA
dc.date.accessioned2015-07-03T08:30:26Z
dc.date.available2015-07-03T08:30:26Z
dc.date.issued2014en_ZA
dc.descriptionIncludes bibliographical references.en_ZA
dc.description.abstractWithin 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.en_ZA
dc.identifier.apacitationPorter, M. (2014). <i>Outcomes of infants starting Antiretroviral therapy in Southern Africa</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/13343en_ZA
dc.identifier.chicagocitationPorter, Mireille. <i>"Outcomes of infants starting Antiretroviral therapy in Southern Africa."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2014. http://hdl.handle.net/11427/13343en_ZA
dc.identifier.citationPorter, M. 2014. Outcomes of infants starting Antiretroviral therapy in Southern Africa. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Porter, Mireille AB - 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. DA - 2014 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Outcomes of infants starting Antiretroviral therapy in Southern Africa TI - Outcomes of infants starting Antiretroviral therapy in Southern Africa UR - http://hdl.handle.net/11427/13343 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/13343
dc.identifier.vancouvercitationPorter M. Outcomes of infants starting Antiretroviral therapy in Southern Africa. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2014 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/13343en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPublic Healthen_ZA
dc.titleOutcomes of infants starting Antiretroviral therapy in Southern Africaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPHen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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