Cohort Profile: The Paediatric Antiretroviral Treatment Programmes in Lower-Income Countries (KIDS-ART-LINC) Collaboration

Arrivé, Élise; Kyabayinze, Daniel J; Marquis, Benoit; Tumwesigye, Nazarius Mbona; Kieffer, Mary-Pat; Azondekon, Alain; Wemin, Louise; Franco, Patricia; Newell, Marie‐Louise; Leroy, Valériane; Abrams, Elaine J.; Cotton, Mark F.; Boulle, Andrew; Mbori‐Ngacha, Dorothy; Dabis, François

doi:10.1093/ije/dym216

Cited by 28 publications

(27 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Before highly active ART was introduced, HIV-infected infant mortality was high and premature, reaching 35% in the first 12 months of life and 52% within 2 years [3]. Since 2004, following the introduction of ART, reductions in mortality and morbidity among HIV-infected children have been reported [4–8]. Nevertheless, the management of HIV-infected children remains challenging in resource-limited settings, particularly in West Africa [9].…”

Section: Introductionmentioning

confidence: 99%

Reasons for hospitalization in HIV‐infected children in West Africa

Dicko¹,

Desmonde²,

Koumakpaï³

et al. 2014

Journal of the International AIDS Society

View full text Add to dashboard Cite

IntroductionCurrent knowledge on morbidity and mortality in HIV-infected children comes from data collected in specific research programmes, which may offer a different standard of care compared to routine care. We described hospitalization data within a large observational cohort of HIV-infected children in West Africa (IeDEA West Africa collaboration).MethodsWe performed a six-month prospective multicentre survey from April to October 2010 in five HIV-specialized paediatric hospital wards in Ouagadougou, Accra, Cotonou, Dakar and Bamako. Baseline and follow-up data during hospitalization were recorded using a standardized clinical form, and extracted from hospitalization files and local databases. Event validation committees reviewed diagnoses within each centre. HIV-related events were defined according to the WHO definitions.ResultsFrom April to October 2010, 155 HIV-infected children were hospitalized; median age was 3 years [1–8]. Among them, 90 (58%) were confirmed for HIV infection during their stay; 138 (89%) were already receiving cotrimoxazole prophylaxis and 64 children (40%) had initiated antiretroviral therapy (ART). The median length of stay was 13 days (IQR: 7–23); 25 children (16%) died during hospitalization and four (3%) were transferred out. The leading causes of hospitalization were WHO stage 3 opportunistic infections (37%), non-AIDS-defining events (28%), cachexia and other WHO stage 4 events (25%).ConclusionsOverall, most causes of hospitalizations were HIV related but one hospitalization in three was caused by a non-AIDS-defining event, mostly in children on ART. HIV-related fatality is also high despite the scaling-up of access to ART in resource-limited settings.

show abstract

Section: Introductionmentioning

confidence: 99%

Reasons for hospitalization in HIV‐infected children in West Africa

Dicko¹,

Desmonde²,

Koumakpaï³

et al. 2014

Journal of the International AIDS Society

View full text Add to dashboard Cite

show abstract

“…Indeed, these children often began treatment at more than five years of age, an advanced stage of disease, with severe malnutrition and immunosuppression [20,26–31]. …”

Section: Discussionmentioning

confidence: 99%

Antiretroviral treatment response of HIV‐infected children after prevention of mother‐to‐child transmission in West Africa

Ndondoki¹,

Dicko²,

Coffie³

et al. 2014

Journal of the International AIDS Society

View full text Add to dashboard Cite

IntroductionWe assessed the rate of treatment failure of HIV-infected children after 12 months on antiretroviral treatment (ART) in the Paediatric IeDEA West African Collaboration according to their perinatal exposure to antiretroviral drugs for preventing mother-to-child transmission (PMTCT).MethodsA retrospective cohort study in children younger than five years at ART initiation between 2004 and 2009 was nested within the pWADA cohort, in Bamako-Mali and Abidjan-Côte d’Ivoire. Data on PMTCT exposure were collected through a direct review of children’s medical records. The 12-month Kaplan-Meier survival without treatment failure (clinical or immunological) was estimated and their baseline factors studied using a Cox model analysis. Clinical failure was defined as the appearance or reappearance of WHO clinical stage 3 or 4 events or any death occurring within the first 12 months of ART. Immunological failure was defined according to the 2006 World Health Organization age-related immunological thresholds for severe immunodeficiency.ResultsAmong the 1035 eligible children, PMTCT exposure was only documented for 353 children (34.1%) and remained unknown for 682 (65.9%). Among children with a documented PMTCT exposure, 73 (20.7%) were PMTCT exposed, of whom 61.0% were initiated on a protease inhibitor-based regimen, and 280 (79.3%) were PMTCT unexposed. At 12 months on ART, the survival without treatment failure was 40.6% in the PMTCT-exposed group, 25.2% in the unexposed group and 18.5% in the children with unknown exposure status (p=0.002). In univariate analysis, treatment failure was significantly higher in children unexposed (HR 1.4; 95% CI: 1.0–1.9) and with unknown PMTCT exposure (HR 1.5; 95% CI: 1.2–2.1) rather than children PMTCT-exposed (p=0.01). In the adjusted analysis, treatment failure was not significantly associated with PMTCT exposure (p=0.15) but was associated with immunodeficiency (aHR 1.6; 95% CI: 1.4–1.9; p=0.001), AIDS clinical events (aHR 1.4; 95% CI: 1.0–1.9; p=0.02) at ART initiation and receiving care in Mali compared to Côte d’Ivoire (aHR 1.2; 95% CI: 1.0–1.4; p=0.04).ConclusionsDespite a low data quality, PMTCT-exposed West African children did not have a poorer 12-month response to ART than others. Immunodeficiency and AIDS events at ART initiation remain the main predictors associated with treatment failure in this operational context.

show abstract

“…2,4 Only the KIDS-ART-LINC group has previously published an assessment of regional-level ART accessibility and availability of resources for children in developing countries. 5 The objective of this survey was to learn how clinical practices varied and what resources were available in TREAT Asia Pediatric Program sites. Although the sites participating in this survey were predominantly in urban settings and often university-affiliated, hospital-based clinics, these sites are commonly national referral centers that provide advice and direction for pediatric HIV care throughout the region.…”

Section: Discussionmentioning

confidence: 99%

“…This is higher than the 73% on ART in the KIDS-ART-LINC cohort in 2007, but similar to the 91% of vertically infected children on ART in the NICHD International Site Development Initiative (NISDI) regional cohort in Latin American and the Caribbean in 2008. 5,13 Reports of second-line ART use in sub-Saharan Africa have also been much lower than the 20% of children on their second or salvage regimen in the TREAT Asia cohort. [13][14][15] This may be related to the early availability of antiretrovirals in some of the surveyed countries that led to the use of less durable mono-or dual-nucleoside reverse transcriptase inhibitor regimens.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric HIV Clinical Care Resources and Management Practices in Asia: A Regional Survey of the TREAT Asia Pediatric Network

Prasitsuebsai

Bowen²,

Pang³

et al. 2010

AIDS Patient Care and STDs

View full text Add to dashboard Cite

Characterizing intraregional differences in current pediatric HIV care and treatment in Asia can guide the development of clinical practice guidelines and improve the understanding of local resource availability. The Therapeutics Research, Education, and AIDS Training in Asia (TREAT Asia) Pediatric Program is a collaboration of clinics and referral hospitals studying pediatric HIV outcomes in the region. A Web-based survey to characterize clinical management practices and monitoring resources was developed and distributed to 20 sites in January 2008. Seventeen (85%) sites from 6 countries responded through April 2008; 14 (82%) were hospital-based and 16 (94%) were public facilities. Of 4050 HIV-infected children under care, 3606 (89%) were on antiretroviral treatment; 80% were on their first mono-, dual-, or triple-drug regimen and 74% were on nevirapine- or efavirenz-based regimens. Fifteen (88%) sites had consistent access to polymerase chain reaction (PCR) testing for infant diagnosis. All sites had access to CD4 testing, with 13 (76%) routinely monitoring patients every 3-6 months; 7 (41%) sites monitored viral load at 6- to 12-month intervals. Although there is some variation in clinical practices, high levels of treatment and monitoring resources were available at these sites. The availability of PCR for early infant diagnosis positions them to implement recent WHO recommendations to treat HIV-infected children younger than 1 year of age. This information will be used to develop future research and programs to support children with HIV in Asia.

show abstract

Cohort Profile: The Paediatric Antiretroviral Treatment Programmes in Lower-Income Countries (KIDS-ART-LINC) Collaboration

Cited by 28 publications

References 11 publications

Reasons for hospitalization in HIV‐infected children in West Africa

Reasons for hospitalization in HIV‐infected children in West Africa

Antiretroviral treatment response of HIV‐infected children after prevention of mother‐to‐child transmission in West Africa

Pediatric HIV Clinical Care Resources and Management Practices in Asia: A Regional Survey of the TREAT Asia Pediatric Network

Contact Info

Product

Resources

About