HIV-Infected Children in Rural Zambia Achieve Good Immunologic and Virologic Outcomes Two Years after Initiating Antiretroviral Therapy
Author Information
Author(s): Janneke H. van Dijk, Catherine G. Sutcliffe, Bornface Munsanje, Pamela Sinywimaanzi, Francis Hamangaba, Philip E. Thuma, William J. Moss
Primary Institution: Macha Research Trust, Macha Hospital, Choma, Zambia
Hypothesis
Can HIV-infected children in rural Zambia achieve good treatment outcomes after starting antiretroviral therapy?
Conclusion
HIV-infected children receiving treatment in a rural clinic experienced sustained immunologic and virologic improvements.
Supporting Evidence
- The cumulative probabilities of death among children starting ART were 9.0% and 14.4% at 6 and 24 months.
- The mean CD4+ T-cell percentage increased from 16.3% at treatment initiation to 35.0% at 24 months.
- 88.5% of children had undetectable viral load at 6 months, decreasing to 77.8% at 24 months.
- Children with longer travel times were less likely to achieve virologic suppression after 6 months of ART.
Takeaway
Kids with HIV in rural Zambia can get better when they take their medicine, even if they live far from the clinic.
Methodology
A prospective cohort study was conducted assessing treatment outcomes of HIV-infected children receiving antiretroviral therapy over two years.
Potential Biases
The study may not be generalizable to other rural government clinics due to the specific support and staffing at the Macha ART clinic.
Limitations
The study had a small sample size and missing data on adherence and treatment outcomes.
Participant Demographics
Children were primarily under 16 years old, with a median age of 2.67 years, and 49.1% were male.
Statistical Information
P-Value
<0.0001
Confidence Interval
95% CI: 5.8, 13.9
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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