Weight-for-age distributions among children with HIV on antiretroviral therapy in the International epidemiology Databases to Evaluate AIDS (IeDEA) multiregional consortium

Abstract

Objective: Pediatric antiretroviral therapy (ART) for children with HIV (CHIV) must be dosed appropriately for children's changing weights as they grow. To inform accurate estimates of ART formulations and doses needed, we described weight-forage distributions among CHIV on ART in the IeDEA global pediatric collaboration between 2004 and 2016, using data from six regions (East, West, Central, and Southern Africa, Asia-Pacific, and Central/South America and the Caribbean). Results: Overall, 59,862 children contributed to the analysis. Age and weight data were available from 530,080 clinical encounters for girls and 537,894 for boys. For each one-year age stratum from 0 to 15 years, we calculated the proportion of children in each of the weight bands designated by the World Health Organization as relevant to pediatric ART formulations: 0 to < 3 kg, 3 to < 6 kg, 6 to < 10 kg, 10 to < 14 kg, 14 to < 20 kg, 20 to < 25 kg, 25 to < 30 kg, 30 to < 35 kg, 35 to < 40 kg, 40 to < 45 kg, 45 to < 50 kg, 50 to < 55 kg, 55 to < 60 kg, and ≥ 60 kg. Data are reported for the entire cohort, as well as stratified by sex and IeDEA region, calendar year of ART use, and duration on ART at time of assessment (< 12 or ≥ 12 months), provided in data tables. These data are critical to improve the accuracy of forecasting and procurement of pediatric ART formulations as the pediatric HIV epidemic and pediatric HIV treatment strategies evolve.

Global HIV mortality trends among children on antiretroviral treatment corrected for under‐reported deaths: an updated analysis of the International epidemiology Databases to Evaluate AIDS collaboration

“…Accurate estimates of the number of children living with HIV (CHIV) are essential for programme planning and resource allocation [1,2]. Further, the number of deaths among CHIV and paediatric antiretroviral therapy (ART) coverage are important measures of programme effectiveness and progress towards targets such as the Joint United Nations Programme http://onlinelibrary.wiley.com/doi/10.1002/jia2.25780/full | https://doi.org/10.1002/jia2.25780 on HIV/AIDS (UNAIDS) 90-90-90 goal [3].…”

The IeDEA Data Exchange Standard: a common data model for global HIV cohort collaboration

“…Multiregional IeDEA data also have been used by other research groups, including the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER)[27–29], the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE) [30,31], and the ALPHA network [32]. IeDEA also contributes data and scientific expertise to mathematical modeling consortia such as the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) modeling group [33,34] and the UNAIDS Reference Group on Estimates, Modelling and Projections [35–40]. Clear benefits of the IeDEA DES have included substantial increases in data quality observed by data managers and analysts, tangible time savings from standardization when performing repeated data processing, and increased collaboration and perceived added value among participating organizations.…”

Addressing Pediatric HIV Pretreatment Drug Resistance and Virologic Failure in Sub-Saharan Africa: A Cost-Effectiveness Analysis of Diagnostic-Based Strategies in Children ≥3 Years Old

“…Use of dolutegravir (DTG) is expected to address the challenges associated with PDR to NNRTI-based ART. Although DTG was approved for children in 2019 and is now recommended for use as first-line ART [ 14 ], its implementation in low- and middle-income countries (LMIC) has been limited to children weighing more than 20 kg [ 15 ], in effect making it available to only children aged 6 years and older [ 16 ]. This still leaves children 3 years and older but weighing less than 20 kg at increased risk of virologic failure due to the possibility of having PDR.…”