A biregional survey and review of first-line treatment failure and second-line paediatric antiretroviral access and use in Asia and southern Africa
| Autor: | Dina Muktiarti, Suneeta Saghayam, Nia Kurniati, G Van Cutsem, M Thien, Karina Razali, Fujie Zhang, Saphonn, Ning Han, NK Nik Yusoff, Siew Moy Fong, LC Hai, S Saramony, Ung Vibol |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Asia Adolescent Anti-HIV Agents HIV Infections Africa Southern Health Services Accessibility 03 medical and health sciences 0302 clinical medicine Second line Acquired immunodeficiency syndrome (AIDS) 030225 pediatrics Antiretroviral Therapy Highly Active Medicine Humans 030212 general & internal medicine Treatment Failure Child business.industry Research Public Health Environmental and Occupational Health medicine.disease Drug Utilization 3. Good health First line treatment Infectious Diseases Cross-Sectional Studies Child Preschool Female Health Services Research business |
| Zdroj: | Journal of the International AIDS Society |
| ISSN: | 1758-2652 |
| Popis: | Background To better understand the need for paediatric second-line antiretroviral therapy (ART), an ART management survey and a cross-sectional analysis of second-line ART use were conducted in the TREAT Asia Paediatric HIV Observational Database and the IeDEA Southern Africa (International Epidemiologic Databases to Evaluate AIDS) regional cohorts. Methods Surveys were conducted in April 2009. Analysis data from the Asia cohort were collected in March 2009 from 12 centres in Cambodia, India, Indonesia, Malaysia, and Thailand. Data from the IeDEA Southern Africa cohort were finalized in February 2008 from 10 centres in Malawi, Mozambique, South Africa and Zimbabwe. Results Survey responses reflected inter-regional variations in drug access and national guidelines. A total of 1301 children in the TREAT Asia and 4561 children in the IeDEA Southern Africa cohorts met inclusion criteria for the cross-sectional analysis. Ten percent of Asian and 3.3% of African children were on second-line ART at the time of data transfer. Median age (interquartile range) in months at second-line initiation was 120 (78-145) months in the Asian cohort and 66 (29-112) months in the southern African cohort. Regimens varied, and the then current World Health Organization-recommended nucleoside reverse transcriptase combination of abacavir and didanosine was used in less than 5% of children in each region. Conclusions In order to provide life-long ART for children, better use of current first-line regimens and broader access to heat-stable, paediatric second-line and salvage formulations are needed. There will be limited benefit to earlier diagnosis of treatment failure unless providers and patients have access to appropriate drugs for children to switch to. |
| Databáze: | OpenAIRE |
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