Antiretroviral treatment for children
| dc.contributor.author | Eley, Brian | |
| dc.contributor.author | Davies, Mary-Ann | |
| dc.contributor.author | Apolles, Patti | |
| dc.contributor.author | Cowburn, Carol | |
| dc.contributor.author | Buys, Heloise | |
| dc.contributor.author | Zampoli, Marco | |
| dc.contributor.author | Finlayson, Heather | |
| dc.contributor.author | King, Spasina | |
| dc.contributor.author | Nuttall, James | |
| dc.date.accessioned | 2016-01-22T11:40:46Z | |
| dc.date.available | 2016-01-22T11:40:46Z | |
| dc.date.issued | 2006 | |
| dc.date.updated | 2016-01-19T09:43:11Z | |
| dc.description.abstract | Objective: To describe the response of children during their first year on highly active antiretroviral therapy (HAART). Design: Retrospective, descriptive. Setting. Tertiary, referral hospital. Subjects: All HIV-infected children commenced on HAART from 1 August 2002 until 31 December 2004. Outcome measures: Children were retrospectively restaged using the WHO 4-stage clinical classification and CDC immunological staging system. After commencing HAART, patients were assessed at monthly intervals for the first 6 months and thereafter mostly 3-monthly. Baseline and 6- monthly CD4 counts and viral loads were performed. Results. Of 409 children commenced on HAART, 50.6% were < 2 years old, 62.7% had severe clinical disease and 76.6% had severe immune suppression. After 1 year, 65.8% were alive and continued HAART at the hospital, 11.2% had been transferred to another antiretroviral site, 15.4% had died, 4.6% were lost to follow-up and treatment had been discontinued in 2.9%. Kaplan-Meier survival estimate for 407 children at 1 year was 84% (95% confidence interval (CI) 80 - 87%). On multivariate analysis, survival was adversely affected in children with WHO stage 4 v. stage 2 and 3 disease (adjusted hazard ratio (HR): 5.26 (95% CI 2.25 - 12.32), p = 0.000), age < 12 months (adjusted HR: 2.46 (95% CI 1.48 - 4.09), p = 0.001) and CD4 absolute count (per 100 cell increase) (adjusted HR: 0.93 (95% CI 0.88 - 0.98), p = 0.013). In a separate multivariate model including only children with an initial viral load (N = 367), viral load r 1 million copies/ml (adjusted HR: 1.84 (95% CI 1.03 - 3.29)) and taking a protease inhibitor (PI)-based regimen (adjusted HR: 2.25 (95% CI 1.10 - 4.61)) were additionally independently associated with poorer survival; however, young age was not a significant predictor of mortality, after adjusting for viral load (p = 0.119). After 1 year of HAART 184/264 (69.7%) of children had a viral load < 400 copies/ml. Comparative analysis showed significant improvements in growth, immunological status and virological control. Conclusion: HAART can improve the health of many HIVinfected children with advanced disease, including those aged less than 2 years in resource-limited settings. | en_ZA |
| dc.identifier | http://dx.doi.org/10.7196/SAMJ.1300 | |
| dc.identifier.apacitation | Eley, B., Davies, M., Apolles, P., Cowburn, C., Buys, H., Zampoli, M., ... Nuttall, J. (2006). Antiretroviral treatment for children. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/16517 | en_ZA |
| dc.identifier.chicagocitation | Eley, Brian, Mary-Ann Davies, Patti Apolles, Carol Cowburn, Heloise Buys, Marco Zampoli, Heather Finlayson, Spasina King, and James Nuttall "Antiretroviral treatment for children." <i>South African Medical Journal</i> (2006) http://hdl.handle.net/11427/16517 | en_ZA |
| dc.identifier.citation | Eley, B., Davies, M. A., Apolles, P., Cowburn, C., Buys, H., Zampoli, M., ... & Nuttall, J. (2006). Antiretroviral treatment for children. South African medical journal, 96(9), 988-993. | en_ZA |
| dc.identifier.issn | 0256-9574 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Eley, Brian AU - Davies, Mary-Ann AU - Apolles, Patti AU - Cowburn, Carol AU - Buys, Heloise AU - Zampoli, Marco AU - Finlayson, Heather AU - King, Spasina AU - Nuttall, James AB - Objective: To describe the response of children during their first year on highly active antiretroviral therapy (HAART). Design: Retrospective, descriptive. Setting. Tertiary, referral hospital. Subjects: All HIV-infected children commenced on HAART from 1 August 2002 until 31 December 2004. Outcome measures: Children were retrospectively restaged using the WHO 4-stage clinical classification and CDC immunological staging system. After commencing HAART, patients were assessed at monthly intervals for the first 6 months and thereafter mostly 3-monthly. Baseline and 6- monthly CD4 counts and viral loads were performed. Results. Of 409 children commenced on HAART, 50.6% were < 2 years old, 62.7% had severe clinical disease and 76.6% had severe immune suppression. After 1 year, 65.8% were alive and continued HAART at the hospital, 11.2% had been transferred to another antiretroviral site, 15.4% had died, 4.6% were lost to follow-up and treatment had been discontinued in 2.9%. Kaplan-Meier survival estimate for 407 children at 1 year was 84% (95% confidence interval (CI) 80 - 87%). On multivariate analysis, survival was adversely affected in children with WHO stage 4 v. stage 2 and 3 disease (adjusted hazard ratio (HR): 5.26 (95% CI 2.25 - 12.32), p = 0.000), age < 12 months (adjusted HR: 2.46 (95% CI 1.48 - 4.09), p = 0.001) and CD4 absolute count (per 100 cell increase) (adjusted HR: 0.93 (95% CI 0.88 - 0.98), p = 0.013). In a separate multivariate model including only children with an initial viral load (N = 367), viral load r 1 million copies/ml (adjusted HR: 1.84 (95% CI 1.03 - 3.29)) and taking a protease inhibitor (PI)-based regimen (adjusted HR: 2.25 (95% CI 1.10 - 4.61)) were additionally independently associated with poorer survival; however, young age was not a significant predictor of mortality, after adjusting for viral load (p = 0.119). After 1 year of HAART 184/264 (69.7%) of children had a viral load < 400 copies/ml. Comparative analysis showed significant improvements in growth, immunological status and virological control. Conclusion: HAART can improve the health of many HIVinfected children with advanced disease, including those aged less than 2 years in resource-limited settings. DA - 2006 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2006 SM - 0256-9574 T1 - Antiretroviral treatment for children TI - Antiretroviral treatment for children UR - http://hdl.handle.net/11427/16517 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/16517 | |
| dc.identifier.vancouvercitation | Eley B, Davies M, Apolles P, Cowburn C, Buys H, Zampoli M, et al. Antiretroviral treatment for children. South African Medical Journal. 2006; http://hdl.handle.net/11427/16517. | en_ZA |
| dc.language | eng | en_ZA |
| dc.publisher | Health and Medical Publishing Group | en_ZA |
| 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 | en_ZA |
| dc.source.uri | http://www.samj.org.za/index.php/samj | |
| dc.title | Antiretroviral treatment for children | en_ZA |
| dc.type | Journal Article | en_ZA |
| uct.subject.keywords | antiretroviral | en_ZA |
| uct.subject.keywords | children | en_ZA |
| uct.type.filetype | Text | |
| uct.type.filetype | Image | |
| uct.type.publication | Research | en_ZA |
| uct.type.resource | Article | en_ZA |