Efficacy and safety of abacavir-containing combination antiretroviral therapy as first-line treatment of HIV infected children and adolescents: a systematic review and meta-analysis

Adetokunboh, Olatunji; Schoonees, Anel; Balogun, Tolulope; Wiysonge, Charles Shey

doi:10.1186/s12879-015-1183-6

Cited by 12 publications

(6 citation statements)

References 32 publications

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“…Studies show that insu cient or low literacy is linked to low levels of protective behaviour and can eventually lead to vaccine hesitancy (Biasio, 2017;. Our ndings here also re ect previous studies across Africa, suggesting that residents with low adult literacy have lower acceptance of vaccination (Adetokunboh et al, 2015;Adamu et al, 2021). Vaccination messaging should be target-driven.…”

Section: Discussionsupporting

confidence: 84%

Exploring the Drivers of Vaccine Hesitancy Toward Childhood and Adolescent Vaccination in Malawi: A Qualitative Study

Adeyanju¹,

Betsch²,

Adamu³

et al. 2021

Preprint

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Background: Vaccine hesitancy is the delay or refusal of vaccines despite the availability of vaccination services. Although it is considered an important global health threat, it has only rarely been systematically studied within the African context. In this study, we explored the factors that influence vaccine hesitancy among caregivers of children and adolescent girls that are eligible for routine childhood immunisation and the human papillomavirus (HPV) vaccine in Malawi. Methods: The study employed a qualitative exploratory research design. In-depth information was obtained from caregivers of children and adolescent girls eligible for routine immunisation (RI) and the HPV vaccine, respectively, as well as national and district-level representatives of the expanded program on immunisation (EPI) and community stakeholders through key informant interviews and focus-group discussions. These participants were purposively selected using predefined criteria A total of 25 key informant interviews and two focus-group discussions with 13 participants were conducted. Data collection took place between April 20 and May 24, 2020. The interviews were audio-recorded, transcribed verbatim, and then analysed using a thematic content analysis approach. Results: The study shows that most of the vaccine-hesitancy drivers for RI also influenced the newly introduced HPV vaccine. Such drivers were inadequate awareness of the vaccination schedule, rumours and conspiracy theories exacerbated by religious beliefs, inability to translate knowledge and attitudes into actual vaccination behaviour, low literacy levels of caregivers, complacency occasioned by the stress of distance and transportation logistics, and disconnection between the community healthcare system and community leaders, among others. Conclusion: This study provides deeper insights into the determinants of vaccine hesitancy within the Malawian context. The findings can inform the design of context-specific interventions by decision-makers. While the study provided behavioural insights regarding vaccination behaviour in Malawi, there is need for further quantitative studies that can assess the prevalence of the determinants as well as their causal relationships to vaccine uptake.

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Section: Discussionsupporting

confidence: 84%

Exploring the Drivers of Vaccine Hesitancy Toward Childhood and Adolescent Vaccination in Malawi: A Qualitative Study

Adeyanju¹,

Betsch²,

Adamu³

et al. 2021

Preprint

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“…This RCT compared the NRTIs ABC, AZT and d4T in HIV-infected African children, and found that all three NRTIs had similar outcomes in terms of clinical, immunological and virological responses (9). A finding by Adetokunboh et al also concluded that ABC based regimen in children had similar efficacy and safety profile with AZT based regimens (24). In contrary, the PENTA-5 trial demonstrated greater efficacy of ABC based regimen over AZT (16).…”

Section: Discussionmentioning

confidence: 99%

Abacavir versus Zidovudine-Based Regimens for treatment of HIV-Infected Children in resource limited settings: A Retrospective Cohort Study

Mega

Usamo

Negera

2020

Preprint

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BackgroundAbacavir (ABC) and Zidovudine(AZT) based regimens are the preferred first line nucleoside reverse transcriptase (NRTIs) backbones being widely utilized for managing HIV infection in children. However, there is a dearth of data regarding the clinical outcomes and associated risk factors in Ethiopia. We compared the proportion of mortality and the rate of occurrence of Opportunistic Infections (OIs) with ABC versus AZT based regimens in a cohort of HIV-infected children. MethodsA 42 months retrospective cohort study was conducted. A total of 179 records were reviewed by including data from October 2014 to April 2017. Data were collected on socio-demographic, clinical characteristics of patients and drug related variables. Data were analyzed using STATA13.1. Kaplan-Meier and Cox regression were used to compare survival experience and identify independent predictors. Propensity score matching analysis was conducted to elucidate the average treatment effects of each regimen over OIs.ResultOf 179 patients, 98 (54.7%) were females. The mean (+SD) age of the study subjects was 6.53 ± 2.83 years. Through 42 months analysis, a total of 4 patients (1 (1.14%) from ABC group and 3 (3.3%) from AZT group (p=0.339)) were died. The incidence of opportunistic infections attributed to ABC group was 8.77/100,000 person years (py) and that of AZT was 6.9/100,000py. The incidence rate ratio (IRR) for OIs was (IRR=0.87, 95% CI [0.49-1.53] (p=0.304). Baseline CD4 count (AHR= 0.99, 95% CI [0.98-0.99]), Severe acute malnutrition AHR=15.92, 95% CI [5.34-47.50], and exposure to tuberculosis treatment (AHR=2.93, 95% CI [1.39-6.17]) were the independent predictors for the development of OIs. ConclusionABC and AZT based ART regimens seem to have comparable survival benefit among HIV-infected children in Ethiopia. Therefore, both regimens might be used as an alternative in resource limited settings.

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“…This RCT compared the NRTIs ABC, AZT and d4T in HIV-infected African children, and found that all three NRTIs had similar outcomes in terms of clinical, immunological and virological responses [11]. A finding by Adetokunboh et al also concluded that ABC based regimen in children had similar efficacy and safety profile with AZT based regimens [25]. In contrary, the PENTA-5 trial demonstrated greater efficacy of ABC based regimen over AZT [18].…”

Section: Discussionmentioning

confidence: 99%

Abacavir versus Zidovudine-based regimens for treatment of HIV-infected children in resource limited settings: a retrospective cohort study

2020

View full text Add to dashboard Cite

Background: Abacavir (ABC) and Zidovudine (AZT) based regimens are the preferred first line nucleoside reverse transcriptase (NRTIs) backbones being widely utilized for managing HIV infection in children. However, there is a dearth of data regarding the clinical outcomes and associated risk factors in Ethiopia. We compared the proportion of mortality and the rate of occurrence of Opportunistic Infections (OIs) with ABC versus AZT-based regimens in a cohort of HIV-infected children. Methods: A 42 months retrospective cohort study was conducted. A total of 179 records were reviewed by including data from October 2014 to April 2017. Data were collected on socio-demographic, clinical characteristics of patients and drug related variables. Data were analyzed using STATA13.1. Kaplan-Meier and Cox regression were used to compare survival experience and identify independent predictors. Propensity score matching analysis was conducted to elucidate the average treatment effects of each regimen over OIs. Result: Of 179 patients, 98 (54.7%) were females. The mean (+SD) age of the study subjects was 6.53 ± 2.83 years. Through 42 months analysis, a total of 4 patients (1 (1.14%) from ABC group and 3 (3.3%) from AZT group (p = 0.339)) were died. The incidence of opportunistic infections attributed to ABC group was 8.77/100,000 person years (py) and that of AZT was 6.9/100,000py. The incidence rate ratio (IRR) for OIs was (IRR = 0.87, 95% CI [0.49-1.53] (p = 0.304). Baseline CD4 count (AHR = 0.99, 95% CI [0.98-0.99]), Severe acute malnutrition (AHR = 15.92, 95% CI [5.34-47.50]), and exposure to tuberculosis treatment (AHR = 2.93, 95% CI [1.39-6.17]) were the independent predictors for the development of OIs. Conclusion: ABC and AZT based ART regimens seem to have comparable survival benefit among HIV-infected children in Ethiopia. Therefore, both regimens might be used as an alternative in resource limited settings.

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Efficacy and safety of abacavir-containing combination antiretroviral therapy as first-line treatment of HIV infected children and adolescents: a systematic review and meta-analysis

Cited by 12 publications

References 32 publications

Exploring the Drivers of Vaccine Hesitancy Toward Childhood and Adolescent Vaccination in Malawi: A Qualitative Study

Exploring the Drivers of Vaccine Hesitancy Toward Childhood and Adolescent Vaccination in Malawi: A Qualitative Study

Abacavir versus Zidovudine-Based Regimens for treatment of HIV-Infected Children in resource limited settings: A Retrospective Cohort Study

Abacavir versus Zidovudine-based regimens for treatment of HIV-infected children in resource limited settings: a retrospective cohort study

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