17th International AIDS Conference Mexico City, Mexico - August 13 - 18, 2008

VIROLOGICAL SUPPRESSION IN CHILDREN RECEIVING ART IN AN URBAN SOUTH AFRICAN SETTING

Int Conf AIDS. 2008 Aug 13-18;17 Abstract No. MoAb0104

N. Waja, A. Jordan, V. Kgakgadi , A. Coovadia, K. Technau
Coronation Women and Children Hospital, Empilweni HIV Clinic, Johannesburg, South Africa

AIM: To report on viral load suppression in HIV-1 infected children receiving triple anti-retroviral therapy (ART) at Coronation Women and Children Hospital (CWCH) in South Africa regarding age at initiation of ART.

BACKGROUND: Many challenges have been identified since the public provision of ART in April 2004 in South Africa. Literature indicates high rates of rapid progression in Africa require early ART initiation. Data on how age at initiation of ART affects suppression is needed to identify intervention strategies, ensuring the success of ART.

METHODS: All HIV-1 infected children on ART with 3, 6 and 18 month viral load results, attending CWCH paediatric HIV clinic, were reveiwed. Results were correlated with age at initiation of ART, which was grouped into 0-18 months, 19-60 months and more than 60 months. A viral load of less than 25 copies/ml was considered “fully suppressed”.

RESULTS: Of 1128 children who started ART, 418 had a viral load result at 3 months, 411 at 6 months and 266 at 18 months post-initiation. 261 children had a three or six month and an 18 month result. The suppression rate at 3 and 6 months was significantly lower (p=0.000001 and 0.02 respectively) in children started on ART before age 18 months. Without age stratification children not suppressed by 3 or 6 months had a significant risk of suppression failure by 18 months (p=0.001).

CONCLUSIONS: Children starting ART at a younger age were less likely to be suppressed by three and six months post-initiation. Children not suppressed by three or six months post-initiation were less likely to be suppressed by 18 months post-initiation.Further studies are required regarding the relationship between age at initiation of ART and time to virological suppression to elucidate the underlying causes that make the younger age group more vulnerable to suppression failure.

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2008-08-13
MoAb0104

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