LOGIN

International Epidemiology Databases to Evaluate AIDS

Home >> Publications >> Outcomes of Infants Starting Antiretroviral Therapy in Southern Africa, 2004-2012.

Publication

Author(s):

Porter M, Davies MA, Mapani MK, Rabie H, Phiri S, Nuttall J, Fairlie L, Technau KG, Stinson K, Wood R, Wellington M, Haas AD, Giddy J, Tanser F, Eley B.

Pub Title:

Outcomes of Infants Starting Antiretroviral Therapy in Southern Africa, 2004-2012.

Pub Date:

Aug 15 2015

Pub Region(s):

Southern Africa

Page Number:
593-601

Journal:

Title: 
JAIDS- Journal of Acquired Immune Deficiency Syndromes
Link: 
http://ovidsp.tx.ovid.com/sp-3.17.0a/ovidweb.cgi?QS2=434f4e1a73d37e8cd0a0337826dace8383346816a618de05cbc6c74bcd718cbf3ed9b470131f9c8a42186311ccf9ecc115d4852b54877a3fc1bd23250c38f2358937ef2d48f6eac154bc6561ab2d3f80cdb41015018c6dacdf7afeef49607f321c20d6f644

PubMed: 26167620

BACKGROUND:

There are limited published data on the outcomes of infants starting antiretroviral therapy (ART) in routine care in Southern Africa. This study aimed to examine the baseline characteristics and outcomes of infants initiating ART.

METHODS:

We analyzed prospectively collected cohort data from routine ART initiation in infants from 11 cohorts contributing to the International Epidemiologic Database to Evaluate AIDS in Southern Africa. We included ART-naive HIV-infected infants aged <12 months initiating ≥3 antiretroviral drugs between 2004 and 2012. Kaplan-Meier estimates were calculated for mortality, loss to follow-up (LTFU), transfer out, and virological suppression. We used Cox proportional hazard models stratified by cohort to determine baseline characteristics associated with outcomes mortality and virological suppression.

RESULTS:

The median (interquartile range) age at ART initiation of 4945 infants was 5.9 months (3.7-8.7) with follow-up of 11.2 months (2.8-20.0). At ART initiation, 77% had WHO clinical stage 3 or 4 disease and 87% were severely immunosuppressed. Three-year mortality probability was 16% and LTFU 29%. Severe immunosuppression, WHO stage 3 or 4, anemia, being severely underweight, and initiation of treatment before 2010 were associated with higher mortality. At 12 months after ART initiation, 17% of infants were severely immunosuppressed and the probability of attaining virological suppression was 56%.

CONCLUSIONS:

Most infants initiating ART in Southern Africa had severe disease with high probability of LTFU and mortality on ART. Although the majority of infants remaining in care showed immune recovery and virological suppression, these responses were suboptimal.

 

The following websites provide guidelines and policies when citing from PubMed®: http://www.ncbi.nlm.nih.gov/books/NBK7243/
http://www.nlm.nih.gov/bsd/policy/cit_format.html

Citation:

Porter M, Davies MA, Mapani MK, Rabie H, Phiri S, Nuttall J, Fairlie L, Technau KG, Stinson K, Wood R, et al. Outcomes of Infants Starting Antiretroviral Therapy in Southern Africa, 2004-2012. J Acquir Immune Defic Syndr. 2015 Aug 15;69(5):593-601. doi: 10.1097/QAI.0000000000000683. PubMed PMID: 26167620; PubMed Central PMCID: PMC4509628.