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Clinical, Virologic, Immunologic Outcomes and Emerging HIV Drug Resistance Patterns in Children and Adolescents in

A T Makadzange1,2, M Higgins-Biddle3, B Chimukangara2,4

  • 1Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, United States of America.

Plos One
|December 15, 2015
PubMed

Insights

Delayed antiretroviral therapy (ART) initiation in children and adolescents with HIV negatively impacts immune recovery, growth, and virologic outcomes. Early ART initiation is crucial for better long-term health in pediatric HIV care.

Area of Science:

  • Pediatric infectious diseases
  • HIV/AIDS research
  • Public health in low-income countries

Background:

  • Routine HIV care programs in low-income countries face challenges in managing pediatric patients.
  • Understanding outcomes for children and adolescents on antiretroviral therapy (ART) is critical for program improvement.

Purpose of the Study:

  • To evaluate immunologic, virologic outcomes, and drug resistance in children and adolescents receiving HIV care.
  • To assess the impact of age at ART initiation on health outcomes in a programmatic setting.

Main Methods:

  • Cross-sectional study of 599 children and adolescents in a public ART program in Harare.
  • Collection of clinical and laboratory data, including longitudinal records.

Main Results:

  • Delayed ART initiation was associated with lower CD4 counts, severe stunting, and higher rates of virologic failure.
  • Drug resistance was prevalent (67.6%); nevirapine-based regimens increased failure risk in children.
  • Longer ART duration and earlier initiation in adolescence were linked to reduced virologic failure.

Conclusions:

  • Delayed ART initiation in children and adolescents has significant long-term negative effects on immune recovery, growth, and virologic control.
  • Optimizing ART initiation timing is essential for improving long-term outcomes in pediatric HIV care programs.
Abstract

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