Antiretroviral therapy for the management of HIV in children

Frigati, Lisa; Cotton, Mark F.; Rabie, Helena

doi:10.7196/samj.9091

Cited by 4 publications

(2 citation statements)

References 29 publications

(34 reference statements)

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“…Research suggests that children with more advanced disease progression and associated poor growth at ART initiation may show larger improvements in weight gain when compared to children who weigh more at initiation of ART. 31 , 32 , 33 This may have contributed to a threshold effect and also served as the justification behind the subgroup analysis that was performed in this study. The aim was to assess whether the participants who were at a low baseline weight (WAZ < −1) showed different growth patterns from the total group.…”

Section: Discussionmentioning

confidence: 99%

Weight gain in children from birth to 10 years on antiretroviral treatment

Scholtz

Ellis²,

Kruger³

2022

Southern African Journal of HIV Medicine

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Background: Inadequate weight gain could indicate clinical deterioration in infants and children living with HIV (CLHIV). The World Health Organization’s (WHO) weight-for-age z-score (WAZ) growth standards and reference charts are currently used in South Africa to assess weight gain in CLHIV on antiretroviral treatment (ART).Objectives: To assess weight gain patterns of infants and children initiated on ART and to compare weight gain patterns between the WHO WAZ growth standards and population-specific curves constructed from data of CLHIV on ART.Method: A quantitative, retrospective and descriptive-comparative design was used. The weight gain patterns of 98 infants and children from birth to 10 years old during the 24-month period following ART initiation were recorded and assessed using two different growth charts.Results: The children’s rate of weight and length gain improved significantly over 24 months since ART initiation, but complete catch-up growth was never achieved. Most (69%) of the children had increased weight gain according to the WAZ growth standard and reference charts versus only 16% according to the HIV-specific weight gain curves.Conclusion: Antiretroviral treatment improved weight and height gain in CLHIV, but the interpretations of weight gain differed significantly between the WHO chart and HIV-specific weight gain curves. Population- and treatment-specific references could improve weight monitoring in CLHIV and assist in the timeous identification of malnutrition.

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Section: Discussionmentioning

confidence: 99%

Weight gain in children from birth to 10 years on antiretroviral treatment

Scholtz

Ellis²,

Kruger³

2022

Southern African Journal of HIV Medicine

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“…The strategies should be comprehensive, evidence-based, and focused on the rational long-term use of ART in children and adolescents [93][94][95]. Although early mortality and retention in care has been identified by different scholars as early as the year 2002 to be remaining as a significant challenge in HIV programmes, the majority of reports from low-and middle-income countries (LMICs) had in the past decade shown encouraging immunological, virological, and survival outcomes [96][97][98][99][100][101][102][103], with lower than expected reported rates of switching to second-line ART regimens [104,105], and this was back then attributed to being in part due to actual rates of treatment success, but mainly because of the limited access to both virological monitoring and the unavailability of second-line antiretroviral drugs [105].…”

Section: Strategies For Promoting the Rational Use Of Antiretroviral ...mentioning

confidence: 99%

Strategies towards Empowering Nurses on the Rational Use of Antiretrovirals in Children Initiated and Managed on Therapy in Rural Primary Healthcare Clinics of South Africa

Mabila¹,

Demana²,

Mothiba³

2023

Rural Health - Investment, Research and Implications

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HIV has affected the health and welfare of children and undermined the success of child survival in some countries. The introduction of antiretroviral therapy (ART) in managing HIV is one great public health success story. ART has commanded increased survival for people living with HIV (PLHIV). Barriers to achieving ART outcomes in children have been simplifying the prescribing process for non-paediatricians, such as medical doctors and nurses familiar with prescribing ART for adults but involved in treating children, particularly at the primary health care level. And the lack of appropriate antiretroviral formulations for children. The calculation of individualised doses for liquid oral ARVs for children at each clinic visit is considered complicated and time-consuming. ART failure among children seems to be an under-recognised issue, and adherence to treatment guidelines is reported to be a challenge among nurses caring for children and PLWHIV. Rational medicine use is essential to ensure the success of pharmacologic interventions. The attainment of ART goals depends on the effective use ARVs as recommended in guidelines. It is pivotal that nurses be empowered with strategies aimed at promoting the rational use of antiretrovirals.

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Reduced Time to Suppression Among Neonates With HIV Initiating Antiretroviral Therapy Within 7 Days After Birth

Domínguez‐Rodríguez

Tagarro

Foster

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

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There are limited data on infants with HIV starting antiretroviral therapy (ART) in the neonatal period. We investigated the association between the timing of ART initiation and time-to-suppression among infants who tested HIV-positive and initiated ART within the first 28 days of life. The effect was estimated using cumulative probability flexible parametric spline models and a multivariable generalized additive mixed model was performed to test nonlinear associations. Forty-four neonates were included. Nineteen (43.2%) initiated ART within 7 days of life and 25 (56.8%) from 8 to 28 days. Infants treated within 7 days were 4-fold more likely to suppress earlier than those treated after 7 days [Hazard ratio (HR) 4.01 (1.7–9.5)]. For each week the ART initiation was delayed, the probability of suppression decreased by 35% (HR 0.65 [0.46–0.92]). Age at ART start was linearly associated with time-to-suppression. However, a linear association with normally distributed residuals was not found between baseline viral load and time-to-suppression, with no association found when baseline viral loads were ≤5 log(10) copies/mL, but with exponential increase in time-to-suppression with > log5 copies/mL at baseline. Starting ART within 7 days of life led to 4-fold faster time to viral suppression, in comparison to initiation from 8 to 28 days.

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Antiretroviral therapy for the management of HIV in children

Cited by 4 publications

References 29 publications

Weight gain in children from birth to 10 years on antiretroviral treatment

Weight gain in children from birth to 10 years on antiretroviral treatment

Strategies towards Empowering Nurses on the Rational Use of Antiretrovirals in Children Initiated and Managed on Therapy in Rural Primary Healthcare Clinics of South Africa

Reduced Time to Suppression Among Neonates With HIV Initiating Antiretroviral Therapy Within 7 Days After Birth

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