Treatment Outcomes of HIV-Infected Adolescents Attending Public-Sector HIV Clinics Across Gauteng and Mpumalanga, South Africa

• DOI: 10.1089/aid.2012.0215
• Publication Date: 2013-02-01T18:07:36Z
• Authors: Denise Evans; Colin Menezes; Kay Mahomed; Philippa Macdonald; Sanlie Untiedt; Leon Levin; Imogen Jaffray; Nainisha Bhana; Cindy Firnhaber; Mhairi Maskew
• Keywords: Adult; Male; Adolescent; Age Factors; HIV Infections; Viral Load; 3. Good health; South Africa; Young Adult; 03 medical and health sciences; Logistic Models; Treatment Outcome; 0302 clinical medicine; Humans; Female; Treatment Failure; Proportional Hazards Models; Retrospective Studies

There is little evidence comparing treatment outcomes between adolescents and other age groups, particularly in resource-limited settings. A retrospective analysis of data from seven HIV clinics across urban Gauteng (n=5) rural Mpumalanga (n=2), South Africa was conducted. The compared HIV-positive antiretroviral (ART)-naive young (10-14 years), older (15-19), adults (20-24 years) to (≥25 initiated onto standard first-line ART April 2004 August 2010. Log-binomial regression used estimate relative risk (RR) failure suppress viral load (≥400 copies/ml) or achieve an adequate CD4 response at 6 12 months. effect group on virological failure, mortality, loss follow-up (LTFU; ≥90 days since scheduled visit date) estimated using Cox proportional hazards models. Of 42,427 patients initiating ART, 310 (0.7%) were adolescents, 342 (0.8%) 1599 (3.8%) adults. Adolescents similar terms proportion male, baseline count, hemoglobin, TB. Compared adults, both (6 months RR 1.75 95% CI 1.25-2.47) 1.33 1.10-1.60 1.64 1.23-2.19) more likely have unsuppressed fail virologically (HR 2.90 1.74-4.86; HR 2.94 1.63-5.31). Among those that died LTFU, the median time initiation until death LTFU 4.7 (IQR 1.5-13.2) 10.9 5.0-22.7), respectively. no difference mortality by category, Young less be any period after 0.43 0.26-0.69) whereas 1.78 1.34-2.36; 1.63 1.41-1.89) HIV-infected 15 24 years poorer response, than receiving ART. Interventions are needed help improve retention care this unique population.