%0 Journal Article
%T Preliminary outcomes of a paediatric highly active antiretroviral therapy cohort from KwaZulu-Natal, South Africa
%A Anand Reddi
%A Sarah C Leeper
%A Anneke C Grobler
%A Rosemary Geddes
%A K Holly France
%A Gillian L Dorse
%A Willem J Vlok
%A Mbali Mntambo
%A Monty Thomas
%A Kristy Nixon
%A Helga L Holst
%A Quarraisha Karim
%A Nigel C Rollins
%A Hoosen M Coovadia
%A Janet Giddy
%J BMC Pediatrics
%D 2007
%I BioMed Central
%R 10.1186/1471-2431-7-13
%X We performed a retrospective cohort study to investigate preliminary outcomes of all children eligible for HAART at Sinikithemba HIV/AIDS clinic in KwaZulu-Natal, South Africa. Immunologic, virologic, clinical, mortality, primary caregiver, and psychosocial variables were collected and analyzed.From August 31, 2003 until October 31, 2005, 151 children initiated HAART. The median age at HAART initiation was 5.7 years (range 0.3每15.4). Median follow-up time of the cohort after HAART initiation was 8 months (IQR 3.5每13.5). The median change in CD4% from baseline (p < 0.001) was 10.2 (IQR 5.0每13.8) at 6 months (n = 90), and 16.2 (IQR 9.6每20.3) at 12 months (n = 59). Viral loads (VLs) were available for 100 children at 6 months of which 84% had HIV-1 RNA levels ≒ 50 copies/mL. At 12 months, 80.3% (n = 61) had undetectable VLs. Sixty-five out of 88 children (73.8%) reported a significant increase (p < 0.001) in weight after the first month. Eighty-nine percent of the cohort (n = 132) reported ≒ 2 missed doses during any given treatment month (> 95%adherence). Seventeen patients (11.3%) had a regimen change; two (1.3%) were due to antiretroviral toxicity. The Kaplan-Meier one year survival estimate was 90.9% (95%confidence interval (CI) 84.8每94.6). Thirteen children died during follow-up (8.6%), one changed service provider, and no children were lost to follow-up. All 13 deaths occurred in children with advanced HIV disease within 5 months of treatment initiation. In multivariate analysis of baseline variables against mortality using Cox proportional-hazards model, chronic gastroenteritis was associated with death [hazard ratio (HR), 12.34; 95%CI, 1.27每119.71) and an HIV-positive primary caregiver was found to be protective against mortality [HR, 0.12; 95%CI, 0.02每0.88). Age, orphanhood, baseline CD4%, and hemoglobin were not predicators of mortality in our cohort. Fifty-two percent of the cohort had at least one HIV-positive primary caregiver, and 38.4% had at least one p
%U http://www.biomedcentral.com/1471-2431/7/13