High Mortality Following Early Initiation of Antiretroviral Therapy in Infants Living with HIV from Three African Countries
DOI:
10.2139/ssrn.4610012
Publication Date:
2023-11-01T16:14:18Z
AUTHORS (47)
ABSTRACT
Background: Even with increasing access to rapid HIV diagnosis and early ART initiation, HIV-infected infants seem have adverse treatment outcomes. To assess the probability of death, viral suppression, other HIV-related events, we describe outcomes within first three years life among early-treated children perinatally acquired in South Africa, Mozambique, Mali.Methods: We enrolled a cohort who initiated antiretroviral therapy (ART) initial 6 months 3 diagnosis. These were monitored 2, 6, 12 24 weeks after enrolment, followed by biannual check-ups up 4 years. assessed load (VL) severe immunosuppression, healthcare engagement, using Cox multivariable regression models.Findings: Two hundred fifteen for 34 [IQR, 16·3; 44·1]. Anti-retroviral initiation occurred at median days age 26·0; 73·0]. The death year was 10% (95% CI 6-14) increased 12% CI, 8-17) both 2 Risk factors mortality included high baseline VL [HR: 95% CI], region CD4 percentage slope CI]. Sixty-one 146 (41·8%) achieved sustained virological suppression >1 year. Lack associated maternal social events. Assessment adherence considered optimal 81% visits. Female sex birth, lower events risk low adherence.Interpretation: Despite therapy, remains infants. High environment poor Sustained supportive strategies are essential during pregnancy, achieve better survival.Funding: Early Treated Perinatally Infected Individuals: Improving Children's Actual Life (EPIICAL) is research consortium funded ViiV Healthcare led Penta Foundation.Declaration Interest: No confits interest me rest Mali team. All authors nothing declare. Ethical Approval: independent Ethics Institutional review boards all participating institutions Countries approved study. Written informed consent from caregivers/legal representatives obtained.
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