Alemayehu Girma Tessema
Adama Medical College, Ethipoia.
Title: Immuno-virological response to ART in children below 15 years in Adama Referral Hospital, Oromia region, Ethiopia
Biography
Biography: Alemayehu Girma Tessema
Abstract
Background: Introduction of antiretroviral therapy (ART) in sub-Saharan Africa was a hot debate due to many concerns about adherence, logistics and resistance. Currently, it has been significantly scaled up. However as the WHO clinico-immunological approaches for initiation and monitoring of ART in the region lacks viral load determination and drug resistance monitoring, HIV infected children may be at risk for unrecognized virologic failure and the subsequent development of antiretroviral drug resistance.
Aim: To evaluates the virological efficacy and immunological recovery of HIV/AIDS pediatric patients <15 years of age on ART.
Methods: A cross-sectional study was conducted on pediatric patients taking ART at Adama Hospital between February 2011 and October 2013.
Results: Total of 100 children age <15 years of age who started ART during February 2011 and October 2013 was analyzed. Female were 50% with mean age at the start of ART 87.79±41.35 months and median duration on ART was 21.24 months (SD=10.860). The mean CD4+T cell count was 521.04 cells/mm3 (SD=311.118), 698.84 cells/mm3 (SD=400.545), 851.94 cells/mm3 (SD=576.808), 872.13 cells/mm3 (SD=637.627) at 6 months, 12 months, 24 months and 36 months after initiation of ART, respectively. Virological failure (HIV RNA≥1000 copies) was found in 24% of patients. Virological treatment failure (HIV RNA copies ≥1000 copies) was commonly found on 18 males. Significant association was observed between virological treatment failure and duration of months on anti-retroviral treatment (p-value=0.028).
Conclusion & Recommendation: Having adherence level <95%, male sex, longer duration on ART was found to be the independent risk factors for virological treatment failure. The virological treatment failure was seen in clinically stable patients. Based on above data inclusion of routine virological monitoring is the most important follow up parameter for patients on ART to detect early treatment failure and strict counseling and assessment of adherence to anti-retroviral therapy should have to be done for patients on treatment.