Correction: Adoption of routine virologic testing and predictors of virologic failure among HIV-infected children on antiretroviral treatment in western Kenya

Kadima, Julie; Patterson, Elizabeth; Mburu, Margaret; Blat, Cinthia; Nyanduko, Marilyn; Bukusi, Elizabeth A.; Cohen, Craig R.; Oyaro, Patrick; Abuogi, Lisa

doi:10.1371/journal.pone.0210908

Cited by 7 publications

(12 citation statements)

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“…In this study, there was no association between viral suppression and a history of TB. However, in Kenya, a history of TB was associated with viral suppression among children under 15 years (Kadima et al 2019 ), and Zanoni et al ( 2017 ) associated history of TB with higher retention and viral suppression rates among adolescents attending the adolescent clinic. This could be due to close monitoring and adherence support given for TB patients.…”

Section: Discussionmentioning

confidence: 99%

“…Viral suppression for children under 15 years ranged from 40% to 90% in low- and middle-income countries (LMICs) (Kadima et al 2019 ). In SA, a viral suppression rate of 81% was reported among adolescents and young people aged 15–24 years (Zanoni et al 2016 ).…”

Section: Introductionmentioning

confidence: 99%

“…Low viral suppression was common in patients with weakened immune systems, who present with opportunistic infections, on WHO stages III or IV and/or a low CD4 count (< 200 cells/µL) upon initiation on ART. In South Africa, patients on tuberculosis (TB) treatment were reported to have very low viral suppression (Joseph Davey et al 2018 ), while in Kenya, TB co-infection was found to be associated with better virologic outcomes (Kadima et al 2019 ), which may be due to directly observed therapy and adherence support.…”

Section: Introductionmentioning

confidence: 99%

“…The guidelines recommended efavirenz (EFV)-based regimens for children below 15 years as they were more likely to achieve viral suppression compared to being on nevirapine (NVP) – or lopinavir or ritonavir LPV/r-based regimens. In Tanzania and Kenya, protease inhibitor (PI)-based regimens were associated with viral suppression and prevention of drug resistance mutation (DRM) compared to non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens (Kadima et al 2019 ; Muri et al 2017 ), suggesting that PI-based regimens have good performance in viral suppression.…”

Section: Introductionmentioning

confidence: 99%

“…High levels of adherence to therapy are essential to achieve and sustain viral suppression and prevent disease progression to AIDS (Ghanbari et al 2019 ). Poor adherence as a result of poor palatability of drugs, the lack of clinicians’ confidence in treating children with HIV and inadequate psychological support represent the major reasons for failure to follow up and virological failure (VF) in children and adolescents (Fokam et al 2019 ; Kadima et al 2019 ). Retention in care (RiC) is a critical precursor to viral suppression, as it helps maintain adherence, while failure to be retained or interruptions to ART increase the risk of drug resistance and mortality (Murray et al 2017 ).…”

Section: Introductionmentioning

confidence: 99%

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Viral suppression among adolescents on HIV treatment in the Sedibeng District, Gauteng province

Mabizela

Wyk

2022

Curationis

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Background: Progress has been made to increase access to antiretroviral therapy (ART) for adolescents living with HIV (ALHIV) to improve their survival, but ALHIV still have worse treatment adherence and viral suppression compared to adults and children.Objective: To determine the prevalence of viral suppression and the associated factors among adolescents aged 10–19 years on ART at an urban public primary healthcare facility in the Sedibeng district, Gauteng.Method: A cross-sectional survey was conducted among 192 adolescents who were on ART for at least six months between 2015 and 2018. A self-developed data extraction tool was used to collect data from the Tier.Net electronic database and clinical folders. Data were captured on Microsoft Excel, and descriptive and inferential analyses were performed using SPSS 27 statistical software.Results: The median age at ART initiation of adolescents was 9.0 years (interquartile range [IQR]: 5.0–12.0), and the median duration on ART was 70.5 (IQR: 30.25–105.5) months. The prevalence of viral suppression ( 1000 copies/mL) among adolescents on ART was 74%, with 41% achieving full suppression ( 50 copies/mL). Those adolescents who reported optimal ART adherence were more likely to be virally suppressed compared to those who reported poor adherence (98.1% vs 25.0%; p ≤ 0.001).Conclusion: Adolescent viral suppression of 74% is higher than in comparable sites, but still way too short of the UNAIDS target of 90%. We recommend adherence support for adolescents to achieve viral suppression.Contribution: The study highlights the urgent need for targeted adherence support interventions for adolescents living with HIV on antiretroviral therapy to improve rates of viral suppression to meet UNAIDS target of 95%.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Viral suppression among adolescents on HIV treatment in the Sedibeng District, Gauteng province

Mabizela

Wyk

2022

Curationis

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Virologic response of adolescents living with perinatally acquired HIV receiving antiretroviral therapy in the period of early adolescence (10–14 years) in South Africa

Nyakato

Schomaker

Sipambo

et al. 2021

Aids

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Background and objectives: Adolescents living with perinatally acquired HIV (ALPHIV) on antiretroviral therapy (ART) have been noted to have poorer adherence, retention and virologic control compared to adolescents with non-perinatally acquired HIV, children or adults. We aimed to describe and examine factors associated with longitudinal virologic response during early adolescence. Design: A retrospective cohort studyMethods: We included ALPHIV who initiated ART before age 9.5 years in South African cohorts of the International epidemiology Database to Evaluate AIDS-Southern Africa (IeDEA-SA) collaboration (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016); with viral load (VL) values <400 copies/ml at age 10 years and at least one VL measurement after age 10 years. We used a log-linear quantile mixed model to assess factors associated with elevated (75th quantile) VLs. Results:We included 4396 ALPHIV, 50.7% were male, with median (interquartile range) age at ART start of 6.5 (4.5, 8.1) years. Of these, 74.9% were on a non-nucleoside reverse transcriptase inhibitor (NNRTI) at age 10 years. After adjusting for other patient characteristics, the 75th quantile VLs increased with increasing age being 3.13-fold (95% CI 2.66, 3.68) higher at age 14 versus age 10, were 3.25-fold (95% CI 2.81, 3.75) higher for patients on second-line protease-inhibitor and 1.81-fold for second-line NNRTI-based regimens (versus first-line NNRTI-based regimens). There was no difference by sex.

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Rate and predictors of Treatment Failure among pediatric population taking Highly Active Antiretroviral Therapy in Ethiopia

Getaneh

Yizengaw

Likie

et al. 2019

Preprint

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Background: Though the unprecedented global effort at scaling up universal access to antiretroviral therapy (ART) has decreased the progression of HIV, treatment failure (TF) among pediatric patients receiving ART against human immunodeficiency virus (HIV) is becoming a global public health concern which may impact on treatment outcome. Thus, the aim of this study was to determine the rate and predictors of treatment failure (TF) among HIV-infected pediatric patients taking ART in Ethiopia. Methods: A prospective and retrospective follow-up study was conducted from March 2016 to 2017. Retrospective clinical and laboratory data were captured from patients medical record. Socio-demographics and explanatory variables of participants were collected using pre-tested structured questionnaire and study participants were followed for three to six month after baseline viral load has been done to classify virologic failure (VF). TF was ascertained from population who virally failed with the denominator of population taking ART. Chi-square test and multiple logistic regressions were conducted to assess predictors TF. Statistical significance was set at P-value less than 0.05. Results: A total of 554 pediatrics patients taking ART from 40 selected health facilities were included in the study. Viral load suppression (VLS) (VL<1000 copies/ml) among pediatric population taking ART in Ethiopia were found to be 344 (62.1%). From those who was not virally suppressed at baseline of the study 210 (37.9%), 99 (51.6%) were re-suppressed after three to six month of enhanced adherence and counseling, leading the overall virologic failure (VF) among pediatric population taking ART in Ethiopia to be 93 (17.3%). The mean CD4 count was improved from 490 cells/ml at ART initiation to 921 cells/ml after 80 months of ART exposure. Moreover, the clinical outcome was improved from 42% to 89% at ART initiation and after 80 month of ART experience. CD4 count, clinical stage, Hemoglobin and weight were found to be predictors of VF. Moreover; family HIV and disclosure status, duration on ART, age, being orphan, stigma and medication adherence have significant association with VF. Conclusions: The low level of VLS (62.1%) and the high level of VF (18.3%) could explain the challenge on the national ART program among pediatric population. The significant improvement on immunologic and clinical outcome could indicate the success of ART on treatment outcome among pediatric population. CD4 count, clinical stage, Hemoglobin and weight could be good predictors of TF among pediatric population. Improving disclosure status, stigma and medication adherence could improve the treatment outcome of pediatric population taking ART in Ethiopia.

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Correction: Adoption of routine virologic testing and predictors of virologic failure among HIV-infected children on antiretroviral treatment in western Kenya

Cited by 7 publications

References 1 publication

Viral suppression among adolescents on HIV treatment in the Sedibeng District, Gauteng province

Viral suppression among adolescents on HIV treatment in the Sedibeng District, Gauteng province

Virologic response of adolescents living with perinatally acquired HIV receiving antiretroviral therapy in the period of early adolescence (10–14 years) in South Africa

Rate and predictors of Treatment Failure among pediatric population taking Highly Active Antiretroviral Therapy in Ethiopia

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