Outcome of HIV-positive children and adolescents treated with second-line antiretroviral agents in Congo
| Autor: | Beneth Phygarielle Sylvanie Ngoulou, S V Missambou Mandilou, E.R. Nika, J.R. Mabiala Babela, M. Kibangou Lenvo, L.C. Ollandzobo Ikobo |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Medication Adherence Young Adult Therapeutic Adherence ANTIRETROVIRAL AGENTS Second line Acquired immunodeficiency syndrome (AIDS) medicine Humans Child Socioeconomic status Retrospective Studies Transmission (medicine) business.industry Public Health Environmental and Occupational Health medicine.disease Infectious Disease Transmission Vertical Infectious Diseases Anti-Retroviral Agents Congo Social Class Multicenter study Child Preschool Female business |
| Zdroj: | Médecine et Santé Tropicales. 28:413-418 |
| ISSN: | 2261-2211 2261-3684 |
| DOI: | 10.1684/mst.2018.0850 |
| Popis: | Antiretroviral agents (ARVs) are the leading therapeutic weapon against HIV/AIDS infection. When first-line treatment fails, a second-line ARV is needed. OBJECTIVE To determine the prevalence of HIV-infected children treated with second-line ARVs, to assess their adherence and therapeutic response, and to identify factors of good adherence. MATERIAL AND METHODS A retrospective multicenter study covering the period from January 2015 to July 2016 in all centers providing care to children with HIV included all children treated with a second-line ARV. RESULTS A total of 71 children were identified, with a male to female ratio of 1.1 and a mean age of 14.2±3.2 years (range: 5 to 19). Mother-to-child transmission was observed for 97.2 %. In all, 64.8 % of the children had lost at least one parent, 29.6 % both of them. Family socioeconomic status was low for 15.5 % and middle for 74.6 %. Nearly half (46.5 %) were aware of their HIV status, and all received psychological support. The therapeutic regimen used for 54.9 % included ABC + DDI + LPV/r, and the treatment lasted for less than 2 years in 22.5 % and between 2 and 4 years in 38 %. Therapeutic adherence was good in 54.9 %, better in boys (p < 0.01) and in those aged 15 years and younger (p < 0.001). The therapeutic response was good in 89 % at 12 months and 86 % at 4 years, better in those aged 15 years and younger (p < 0.001). CONCLUSION Despite the small proportion of good therapeutic adherence to second-line ARVs, the rate of good clinical and therapeutic response of 86 % in children and adolescents 4 years after being switched to them is an argument that should encourage prescribers to shift patients to second-line treatment as soon as there is an indication. However, challenges remain in improving the management of children and adolescents treated with a second-line ART. |
| Databáze: | OpenAIRE |
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