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Home >> Publications >> Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review.

Publication

Author(s):

Mugglin C, Wandeler G, Estill J, Egger M, Bender N, Davies MA, Keiser O.

Pub Title:

Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review.

Pub Date:

Feb 28 2013

Pub Region(s):

Southern Africa

Journal Issue:

2

Page Number:
e56446

Journal:

Title: 
PLoS One
Link: 
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0056446

PubMed: 23437135
Pub PDF: PDF icon 23437135.pdf

Abstract
BACKGROUND
: In adults it is well documented that there are substantial losses to the programme between HIV testing and start of antiretroviral therapy (ART). The magnitude and reasons for loss to follow-up and death between HIV diagnosis and start of ART in children are not well defined.

METHODS: We searched the PubMed and EMBASE databases for studies on children followed between HIV diagnosis and start of ART in low-income settings. We examined the proportion of children with a CD4 cell count/percentage after after being diagnosed with HIV infection, the number of treatment-eligible children starting ART and predictors of loss to programme. Data were extracted in duplicate.

RESULTS: Eight studies from sub-Saharan Africa and two studies from Asia with a total of 10,741 children were included. Median age ranged from 2.2 to 6.5 years. Between 78.0 and 97.0% of HIV-infected children subsequently had a CD4 cell count/percentage measured, 63.2 to 90.7% of children with an eligibility assessment met the eligibility criteria for the particular setting and time and 39.5 to 99.4% of the eligible children started ART. Three studies reported an association between low CD4 count/percentage and ART initiation while no association was reported for gender. Only two studies reported on pre-ART mortality and found rates of 13 and 6 per 100 person-years.

CONCLUSION: Most children who presented for HIV care met eligibility criteria for ART. There is an urgent need for strategies to improve the access to and retention to care of HIV-infected children in resource-limited settings.

PMID: 23437135 [PubMed - indexed for MEDLINE]

PMCID: PMC3577897

 

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Citation:

Mugglin C, Wandeler G, Estill J, Egger M, Bender N, Davies MA, Keiser O. Retention in care of HIV-infected children from HIV test to start of antiretroviral therapy: systematic review. PLoS One. 2013;8(2):e56446. doi: 10.1371/journal.pone.0056446. Epub 2013 Feb 20. PubMed PMID: 23437135; PubMed Central PMCID: PMC3577897.