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Viral load testing cascade for HIV infected children on non-nucleoside reverse transcriptase inhibitor-based first line regimen at selected health facilities in western Kenya

Title: Viral load testing cascade for HIV infected children on non-nucleoside reverse transcriptase inhibitor-based first line regimen at selected health facilities in western Kenya
Authors: Nyabiage, L.; Musingila, P.; Omondi, M.; Mutwiri, D.; Rono, D.
Source: East African Medical Journal; Vol. 95 No. 12 (2018); 2145-2154 ; 0012-835X
Publisher Information: Kenya Medical Association
Publication Year: 2020
Collection: AJOL - African Journals Online
Description: Background: Viral load (VL) testing is critical in monitoring response to HIV treatment for children.Objectives: To describe access to VL testing and testing outcomes for children on Nevirapine or Efavirenz based first line antiretroviral treatment (ART).Design: Retrospective cohort studySetting: HIV clinics. Participants: Children aged 6 weeks to 14 years.Main outcome measures: VL test results, viral suppression, Methods: We reviewed records of children initiated on ART between 2010 and 2014. Clinic attendance within 90 days was considered active. Virological failure was defined as VL>1000copies/ml while repeat VL>1000c/ml qualified for regimen switch. Analysis used Stata Version 13.1 and Cox proportional hazard ratio was used to explore the association between outcome measures and sociodemographic at p≤0.05 level of significanceResults: Of 3,432 eligible children, 69.1% had VL results and 69.5% achieved viral suppression. Of 3,118 active on ART, 73.1% had VL results and 70.1% achieved viral suppression compared to 314 attritions from care with 29.5% and 55.4% respectively (P500 cells/mm3 compared to age < 2 years and CD4 1000 copies/ml and 58.9% had regimen switch. Of the 809, 308 (38.1%) switched regimen without repeat VL results and 79.9% had follow up VL >1000 copies/ml.Conclusion: Although most children achieved viral suppression, gaps in access to timely VL testing remain a challenge. Children aged >24 months and those switched without repeat VL results need additional support to achieve viral suppression.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: https://www.ajol.info/index.php/eamj/article/view/194561/183787; https://www.ajol.info/index.php/eamj/article/view/194561
Availability: https://www.ajol.info/index.php/eamj/article/view/194561
Accession Number: edsbas.9C1E9077
Database: BASE