High mortality following early initiation of antiretroviral therapy in infants living with HIV from three African countries

Even with increasing access to rapid HIV diagnosis and early antiretroviral therapy (ART) initiation, infants living with HIV seem to have adverse outcomes. We assessed the probability of death, viral suppression, and other HIV-related events in the first three years of life among early-treated chil...

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Detalles Bibliográficos
Autores: Tagarro García, Alfredo, Domínguez Rodríguez, Sara, Cotton, Mark, Otwombe, Kennedy, Klein, Nigel, Lain, Maria Grazia, Nhampossa, Tacilta, Maiga, Almoustapha Issiaka, Barnabas, Shaun, Vaz, Paula, et al.
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universidad Europea (UEM)
Repositorio:ABACUS. Repositorio de Producción Científica
Idioma:inglés
OAI Identifier:oai:abacus.universidadeuropea.com:11268/16038
Acceso en línea:https://hdl.handle.net/11268/16038
Access Level:acceso abierto
Palabra clave:Antirretrovirales
VIH
Transmisión Vertical de Enfermedad Infecciosa
Ciencias médicas
Mortalidad infantil
Enfermedad venérea
Goal 3: Ensure healthy lives and promote well-being for all at all ages
Goal 10: Reduce inequality within and among countries
Descripción
Sumario:Even with increasing access to rapid HIV diagnosis and early antiretroviral therapy (ART) initiation, infants living with HIV seem to have adverse outcomes. We assessed the probability of death, viral suppression, and other HIV-related events in the first three years of life among early-treated children with perinatally-acquired HIV in South Africa, Mozambique, and Mali. We enrolled a cohort of infants who initiated ART within the initial 6 months of life and within 3 months of diagnosis. These children were monitored 2, 6, 12 and 24 weeks after enrolment, followed by biannual check-ups up to 4 years after enrolment. We assessed the probability of death, viral load (VL) suppression, severe immunosuppression (according to WHO guidelines), and engagement in care using Kaplan–Meier plots, and hazard ratios for these outcomes using multivariable Cox regression models. Despite early ART, mortality remains high in infants. High baseline VL and adverse maternal social environment increased the risk of poor outcomes. Sustained supportive strategies are essential during and after pregnancy, to achieve better survival.