Evaluation of parent-child pairs on antiretroviral therapy in separate adult and pediatric clinics

J Int Assoc Provid AIDS Care. 2014 Nov-Dec;13(6):555-9. doi: 10.1177/2325957413503367. Epub 2013 Oct 10.

Abstract

In Africa, HIV infection is considered a family disease. A retrospective cohort analysis was performed to describe the characteristics and outcome in 35 parent-child pairs taking antiretroviral therapy (ART) in separate adult and pediatric HIV clinics. In 26 pairs, ART was first initiated in children. Baseline median CD4 count was 122/mm(3) in adults and 376/mm(3) in children. World Health Organization stage 3 or 4 disease affected 49% of adults and 83% of children. In all, 3 parents and 1 child died. Hospitalization, poor adherence, missed appointments, or regimen change affected >50% of pairs on ART. Following tuberculosis diagnosis in their parents, 2 of the 5 children were not investigated. By week 104, 29 (83%) pairs remained on ART, and 69% of patients on ART were virologically suppressed. Parent-child pairs with advanced HIV infection had good outcomes when cared for in separate clinics. Establishing lines of communication between clinics is important. Family-centered services may provide more integrated care.

Keywords: Africa; HIV; antiretroviral treatment outcomes; children; parents.

MeSH terms

  • Adult
  • Ambulatory Care Facilities*
  • Anti-Retroviral Agents / therapeutic use*
  • CD4 Lymphocyte Count
  • Child
  • Child, Preschool
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • Hospitalization
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Parents
  • Patient Compliance
  • Pediatrics*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Retroviral Agents