15. Results of ARV treatment of HIV infected children at the National Children’s Hospital

Ngo Thi Thu Tuyen, Nguyen Van Lam, Tran Thi Thu Huong

Main Article Content

Abstract

This study was conducted to evaluate the effectiveness of antiretroviral long term treatment of HIV infected children to assist medical staff to develop an successful treatment. A retrospective follow-up study of 312 children under 16 years of age at the time of HIV diagnosis and ART registration at the National Children's Hospital from 01/01/2006 to 30/04/2018 showed the mean age is 15.8 ± 4.1; the male/female ratio is 1.35/1. When starting ART, 53.5% was at the clinical stage 3, 4, 69.6% had TCD4 count at severe immunodeficiency- this was considered a factor predictive of first-line ART failure (p = 0.031, OR = 2.15 [95%CI: 1.062 - 4.354]). At the time of the study, 93.9% of children had a normal TCD4 count, 94.4% of children had a viral load of less than 200 copies/mm3. During treatment, 62/312 (19.9%) children who failed first-line ART, 13/312 (4.2%) children failed second-line ART. Children who failed first-line ART had 57/62 (91.9%) virological failure and 44/62 (71%) immunological failure.


Keywords: HIV, children HIV treatment, HIV treatment, children, ARV treatment.

Article Details

References

1. What’s New in the Guidelines? | NIH. Accessed March 31, 2022. https://clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv/whats-new-guidelines.
2. Global HIV & AIDS statistics - Fact sheet | UNAIDS. Accessed March 31, 2022. https://www.unaids.org/en/resources/fact-sheet.
3. UNAIDS_FactSheet_en.pdf. Accessed March 31, 2022. https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf.
4. JC3032_AIDS_Data_book_2021_En.pdf. Accessed March 29, 2022. https://www.unaids.org/sites/default/files/media_asset/JC3032_AIDS_Data_book_2021_En.pdf.
5. Wondifraw EB, Tebeje NB, Akanaw W, Chanie ES. Predictors of first-line antiretroviral treatment failure among children on antiretroviral therapy at the University of Gondar comprehensive specialised hospital, North-west, Ethiopia: a 14-year long-term follow-up study. BMJ Open. 2022; 12(12):e064354. doi:10.1136/bmjopen-2022-064354.
6. Childs T, Shingadia D, Goodall R, et al. Outcomes after viral load rebound on first-line antiretroviraltreatment in children with HIV in the UK and Ireland: an observational cohort study. Lancet HIV. 2015; 2(4): e151-158. doi:10.1016/S2352-3018(15)00021-1.
7. Kazooba P, Mayanja BN, Levin J, Masiira B, Kaleebu P. Virological failure on first-line antiretroviral therapy; associated factors and a pragmatic approach for switching to second line therapy-evidence from a prospective cohort study in rural South-Western Uganda, 2004-2011. Pan Afr Med J. 2018; 29: 191. doi:10.11604/pamj.2018.29.191.11940.
8. Low YS, Islahudin F, Razali KAM, Adnan S. Modification of Initial Highly Active Antiretroviral Therapy (HAART) Regimen in Paediatric HIV Patients. Open AIDS J. 2018; 12: 11-19. doi:10.2174/1874613601812010011.
9. BỘ Y TẾ, PHÒNG CHỐNG HIV/AIDS. Quyết định 5968/QĐ-BYT của Bộ trưởng Bộ Y tế Về việc ban hành Hướng dẫn Điều trị và chăm sóc HIV/AIDS. Accessed March 25, 2022. https://vaac.gov.vn/van-ban/59862021.html.
10. Unaids-strategy-2016-2021_draft-for-review_3-august.pdf. Accessed March 29, 2022. https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/unaids-strategy-2016-2021_draft-for-review_3-august.pdf.
11. Pursuing Later Treatment Options II (PLATO II) project team for the Collaboration of Observational HIV Epidemiological Research Europe (COHERE), Castro H, Judd A, et al. Risk of triple-class virological failure in children with HIV: a retrospective cohort study. Lancet Lond Engl. 2011; 377(9777): 1580-1587. doi:10.1016/S0140-6736(11)60208-0.
12. Zeleke A. Prevalence of antiretroviral treatment failure and associated factors in HIV infected children on antiretroviral therapy at Gondar University Hospital, retrospective cohort study. Int J Med Med Sci. 2016; 8(11): 125-132. doi:10.5897/IJMMS2015.1164.
13. Yihun BA, Kibret GD, Leshargie CT. Incidence and predictors of treatment failure among children on first-line antiretroviral therapy in Amhara Region Referral Hospitals, northwest Ethiopia 2018: A retrospective study. PloS One. 2019; 14(5): e0215300. doi:10.1371/journal.pone.0215300.
14. Bacha T, Tilahun B, Worku A. Predictors of treatment failure and time to detection and switching in HIV-infected Ethiopian children receiving first line anti-retroviral therapy. BMC Infect Dis. 2012; 12: 197. doi:10.1186/1471-2334-12-197.
15. Wedajo S, Degu G, Deribew A, Ambaw F. Treatment failure, death, and predictors among PLWHIV on second-line antiretroviral therapy in Dessie Comprehensive Specialized Hospital, northeast Ethiopia: A retrospective cohort study. PloS One. 2022; 17(6): e0269235. doi:10.1371/journal.pone.0269235.