Advanced HIV Disease at Antiretroviral Therapy Initiation and Treatment Outcomes Among Children and Adolescents Compared to Adults Living With HIV in Kinshasa, Democratic Republic of the Congo-Reference-Cited by-同舟云学术

Advanced HIV Disease at Antiretroviral Therapy Initiation and Treatment Outcomes Among Children and Adolescents Compared to Adults Living With HIV in Kinshasa, Democratic Republic of the Congo

Published:2023-01 Issue: Volume:22 Page:
ISSN:2325-9582
Container-title:Journal of the International Association of Providers of AIDS Care (JIAPAC)
language:en
Short-container-title:J Int Assoc Provid AIDS Care

Author:

Chabikuli Otto Nzapfurundi¹²,Ditekemena John D.³⁴,Sigwadhi Lovemore Nyasha⁵,Mulenga Astrid³,Mboyo Aimé⁶,Bidashimwa Dieudonne¹^ORCID,Nachega Jean B.⁷⁸⁹

Affiliation:

1. Family Health International (FHI 360), Durham, NC, USA

2. Public Health Program, Graduate School, Howard University, Washington, DC, USA

3. Family Health International (FHI 360), Kinshasa, Democratic Republic of the Congo

4. Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo

5. Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa

6. National AIDS Control Program, Kinshasa, Democratic Republic of the Congo

7. Departments of Epidemiology, Infectious Diseases and Microbiology and Center for Global Health, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA

8. Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health; Center for Global Health, Johns Hopkins University Baltimore, MD, USA

9. Department of Medicine, Division of Infectious Diseases, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa

Abstract

Background: Little is known about advanced HIV disease (AHD) at antiretroviral therapy (ART) initiation among children and adolescents living with HIV (CALHIV) and related age disparities in the Democratic Republic of the Congo (DRC). Methods: We conducted a retrospective cohort analysis of routine program data collected among adults, adolescents, and children living with HIV in 6 health zones in Kinshasa, DRC from 2005 to 2020. Results: Thirty-two percent of those who initiated ART had AHD. Compared to adults, adolescents had a 15% higher risk of AHD (RR: 1.15; 95% CI: 1.08-1.21; P < .001). Despite their higher risk of AHD, adolescents had a lower risk of mortality (aSHR: 0.72; 95% CI: 0.52-0.99; P = .047) and lower cumulative death events versus adults (aSHR: 0.44; 95% CI: 0.34-0.59; P < .001). Conclusions: ADH at ART initiation is highly prevalent in Kinshasa, DRC, and adolescents are disproportionally impacted. There is a need to scale up high-impact HIV interventions targeting CALHIV.

Funder

Family Health International

Publisher

SAGE Publications

Subject

Infectious Diseases,Dermatology,Immunology

Link

http://journals.sagepub.com/doi/pdf/10.1177/23259582231221955

Reference31 articles.

1. Advanced HIV Disease at Entry into HIV Care and Initiation of Antiretroviral Therapy During 2006-2011: Findings From Four Sub-Saharan African Countries

2. Earlier initiation of antiretroviral therapy, increased tuberculosis case finding and reduced mortality in a setting of improved HIV care: a retrospective cohort study

3. Impact of Antiretroviral Therapy on the Relapse of Cryptococcosis and Survival of HIV-Infected Patients with Cryptococcal Infection