[WeOaLB0201] Very satisfactory outcomes can be achieved in children treated with highly active antiretroviral treatment under program conditions in resource-limited settings: the experience of Médecins Sans Frontières!

3rd International AIDS Society Conference on HIV Pathogenesis and Treatment

Rio de Janeiro - July 24 - 27, 2005

VERY SATISFACTORY OUTCOMES CAN BE ACHIEVED IN CHILDREN TREATED WITH HIGHLY ACTIVE ANTIRETROVIRAL TREATMENT UNDER PROGRAM CONDITIONS IN RESOURCE-LIMITED SETTINGS: THE EXPERIENCE OF MéDECINS SANS FRONTIèRES!

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. WeOaLB0201

AIDS Working Group A.W.G.¹, Epicentre²
¹Médecins Sans Frontières, Luxembourg, Luxembourg, ²Epicentre, Paris, France

OBJECTIVES: To measure outcomes of Highly Active Antiretroviral treatment (HAART) among children placed on treatment under routine program conditions in eleven resource-limited countries.

METHODS: Analysis of cumulative program data gathered until March 2005 using the FUCHIA monitoring software (Fuchia®, Epicentre).

RESULTS: A total of 1840 children aged less than 13 years were placed on HAART of whom 883 (48%) were females. 96% were older than 18 months (median age 5.9 years; intraquartile range: 3.6 – 8.3). At initiation, CDC stages N, A, B and C were respectively 7%, 14%, 36% and 43%. Eighty five percent of children (n-747) had a CD4 count percentage <15%. WHO recommended first line regimens were used in 96% of all children. Follow-up was for a total period of 1399 person years with 54% of the cohort having been on follow up for more than six months and 29% for more than one year. The median weight gain at 6, 12, and 24 months were 2, 3, and 5 kg respectively while median CD4 gain (%) was 9% at 6 months, 11% at 12 months and 13% at 24 months. Treatment outcomes in March 2005 included: 1543 (84%) alive and on HAART, 111 (6%) deaths, 79 (4%) lost to follow up, 28 (1.5%) stopped treatment, 3 (0.2%) transferred out and 76 (4%) with unknown outcomes. Survival probability at 6, 12, and 24 months on HAART was 94%, 92%, and 91% respectively. Side effects meriting alternative treatment were reported in 74 (4%) of children. Only 4 patients have so far required second-line therapy.

CONCLUSIONS: This data shows very satisfactory outcomes (comparable to those in developed countries) among children offered HAART under routine program conditions in resource-limited settings. Our findings strongly favour the rapid integration of HAART for children within the scaling-up process in these settings.

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