Characteristics and Outcomes of HIV-infected Children on Antiretroviral Therapy referred for Vitological failure
Date
2024
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Witwatersrand, Johannesburg
Abstract
Background: The advent of Anti-Retroviral Therapy (ART) has substantially improved virological outcomes for individuals globally living with Human Immunodeficiency Virus. However, the rates of virological suppression in children and adolescents continue to lag behind those observed in adults.
Objectives: This study aims to describe the characteristics and outcomes of children on ART referred to Hariet Shezi Children’s Clinic, Chris Hani Baragwanath Academic Hospital for virological failure. Additionally, the research seeks to identify factors associated with virological failure in this specific population.
Methods: Conducted as a retrospective review, this study examined the records of children living with HIV aged 0-14 years, referred to Hariet Shezi Children’s Clinic, for management of virological failure between 01 January 2010 and 31 December 2019.
Results: Among the 105 patients meeting the inclusion criteria, the median age at referral was 11 years (IQR 6.7-13 years), with 51.4% being male. Significant proportions (37.3%) of patients above the age of 8 were unaware of their HIV status. At referral, 35.2% were on a Non-nucleoside reverse transcriptase inhibitor-based regimen, and 82% had a VL log 10 exceeding 4. Notably, 86.5% of those on NNRTI were switched to a second-line regimen, compared to 4.4% on Protease inhibitor- based regimens. Despite differences in interventions, virological outcomes were similar at 6 ±3 months. Approximately 56.2% of patients received adherence counselling in conjunction with other interventions, indicating that virological failure in the majority resulted from sub-optimal adherence and additional factors. A significant reduction in median viral load was observed at 6 ±3 months and 12±3 months post-intervention (P <0.001).
Conclusion: Viral suppression remains a challenge in the paediatric and adolescent populations. Addressing this challenge necessitates a multifaceted approach involving various interventions. Greater resource allocation towards the optimization of viral suppression rates in children and adolescents living with HIV is imperative
Description
Research report to be submitted as part of the requirements for the degree of Master of Medicine in Paediatrics to the Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, 2024
Keywords
Children living with HIV, Anti-Retroviral Therapy, Virological Failure, Virological Outcomes, UCTD
Citation
Magomani, Xitshembiso Confidence. (2024). Characteristics and Outcomes of HIV-infected Children on Antiretroviral Therapy referred for Vitological failure [Master’s dissertation, University of the Witwatersrand, Johannesburg]. WireDSpace.https://hdl.handle.net/10539/42669