Scaling up antiretroviral therapy for HIV-infected children in Côte d’Ivoire: determinants of survival and loss to programme
M-F Anaky, J Duvignac, L Wemin, A Kouakoussui, S Karcher, S Touré, C Seyler, P Fassinou, F Dabis, T N’Dri-Yoman, X Anglaret & V Leroy
Volume 88, Number 7, July 2010, 490-499
Table 1. Demographic and clinical characteristics of children diagnosed with HIV-1 infection, with or without concurrent HIV-2 infection, and those who initiated antiretroviral therapy (ART) during the Aconda HIV treatment programme, Côte d’Ivoire, 2004–2007
| Characteristic | All children | Aged < 18 months | Aged 18–59 months | Aged ≥ 60 months |
|---|---|---|---|---|
| At HIV diagnosisa | No. = 1 766 | No. = 307 | No. = 586 | No. = 873 |
| Median age in months (IQR) | 54 (22–98) | 9 (4–14) | 31 (23–44) | 99 (76–135) |
| No. of females (%) | 889 (50.3) | 155 (50.5) | 276 (47.1) | 458 (52.5) |
| No. with HIV-1 infection only (%) | 1757 (99.5) | 307 (100) | 584 (97.7) | 866 (99.2) |
| No. with both HIV-1 and HIV-2 infections (%) | 9 (0.5) | 0 (0) | 2 (0.3) | 7 (0.8) |
| No. with CD4 cell count available (%) | 1378 (78.0) | 177 (57.7) | 474 (80.9) | 727 (83.3) |
| Median % of CD4 cells (IQR) | 15.6 (8–22) | 15.3 (11.5–21) | 16.4 (11.0–22.3) | 14.6 (5.6–22) |
| Median CD4 count in cells/µl (IQR) | 487 (212–840) | 800 (462–1240.5) | 684 (402–1065) | 334 (93–606) |
| Median blood haemoglobin in g/dl (IQR) | 9.2 (8.1–10.1) | 9.1 (8.1–9.8) | 9.0 (7.9–10) | 9.4 (8.3–10.3) |
| No. who satisfied criteria for starting ART (%) | 1142 (64.7) | 181 (58.9) | 369 (63.0) | 592 (67.8) |
| Clinical criteria | 374 (21.2) | 45 (14.7) | 103 (17.6) | 226 (25.9) |
| Immunological criteria |
768 (43.5) |
136 (44.3) |
266 (45.4) |
366 (41.9) |
| At ART initiationb | No. = 977 | No. = 145 | No. = 296 | No. = 536 |
| Median age in months (IQR) | 63 (27–109) | 14 (9–16.75) | 34 (26–46) | 107 (81–139) |
| No. of females (%) | 461 (47.2) | 64 (44.1) | 130 (43.9) | 267 (49.8) |
| No. with HIV-1 infection only (%) | 972 (99.5) | 145 (100) | 296 (100) | 531 (99.1) |
| No. with both HIV-1 and HIV-2 infections (%) | 5 (0.5) | 0 (0) | 0 (0) | 5 (0.9) |
| Median weight in kg (IQR) | 14 (10–21) | 7 (6–8.5) | 10.6 (9.4–13) | 20 (15–25) |
| Median weight-for-age z score (IQR) | −3.0 (−4.7 to −1.8) | −3.7 (−5.4 to −2.5) | −2.70 (−4.5 to −1.4) | −3.11 (−4.7 to −1.8) |
| Median % of CD4 cells (IQR) | 10.7 (5.57–15) | 13.0 (9–15.7) | 12.0 (8.02–15.75) | 8.0 (3–14.5) |
| Median CD4 cell count in cells/µl (IQR) | 359 (106.25–712.75) | 714 (475.5–1182.5) | 535 (318.5–875) | 179 (39–423) |
| Median blood haemoglobin in g/dl (IQR) | 9.2 (8.2–10.3) | 9.2 (8.3–10) | 9.3 (8.1–10.3) | 9.2 (8.2–10.3) |
| No. with history of tuberculosis treatment (%) | 26 (2.7) | 3 (2.1) | 14 (4.7) | 9 (1.7) |
| No. with ongoing active tuberculosis (%) | 32 (3.3) | 4 (2.8) | 3 (1.0) | 25 (4.7) |
| No. with WHO HIV/AIDS clinical stage 1 or 2 (%) | 410 (41.9) | 52 (35.9) | 136 (45.9) | 222 (41.4) |
| No. with WHO HIV/AIDS clinical stage 3 or 4 (%) | 422 (43.2) | 57 (39.3) | 117 (39.5) | 248 (46.3) |
| No. who received baseline co-trimoxazole prophylaxis (%) | 529 (54.2) | 95 (65.5) | 171 (57.8) | 263 (49.1) |
| No. who received co-trimoxazole prophylaxis after ART (%) | 874 (89.5) | 128 (88.3) | 268 (90.5) | 478 (89.2) |
| No. who received initial ART regimen (%) | ||||
| 2 NRTIs + 1 NNRTI | 636 (65.1) | 56 (38.6) | 158 (53.4) | 422 (78.3) |
| AZT + 3TC + EFV | 240 (24.6) | 3 (2.1) | 61 (20.6) | 176 (32.8) |
| AZT + 3TC + NVP | 39 (4.0) | 18 (12.4) | 14 (4.7) | 7 (1.3) |
| d4T + 3TC + EFV | 279 (28.6) | 10 (6.9) | 53 (17.9) | 216 (40.3) |
| d4T + 3TC + NVP | 70 (7.2) | 25 (17.2) | 30 (10.1) | 15 (2.8) |
| AZT or d4T or 3TC + DDI + EFV | 8 (0.8) | 0 (0) | 0 (0) | 8 (1.5) |
| 2 NRTIs + 1 PI | 321 (32.9) | 80 (55.2) | 133 (44.9) | 108 (20.1) |
| AZT + 3TC + NFV | 160 (16.4) | 38 (26.2) | 63 (21.3) | 59 (11.0) |
| d4T + 3TC + NFV | 149 (15.3) | 42 (29.0) | 65 (22.0) | 42 (7.8) |
| d4T or 3TC or AZT + DDI + NFV | 12 (1.2) | 0 (0) | 5 (1.7) | 7 (1.3) |
| Other | 20 (2.0) | 9 (6.2) | 5 (1.7) | 6 (1.1) |
3TC, lamivudine; ART, antiretroviral therapy; AZT, azidothymidine; CD4, CD4+ T lymphocyte; d4T, stavudine; DDI, didanosine; EFV, efavirenz; IQR, interquartile range; NFV, nelfinavir; NNRTI, non-nucleoside reverse transcriptase inhibitor; NRTI, nucleoside reverse transcriptase inhibitor; NVP, nevirapine; PI: protease inhibitor.
a Missing values at HIV diagnosis: sex (no. = 1), CD4 cell percentage (no. = 388), CD4 cell count (no. = 377), blood haemoglobin (no. = 349).
b Missing values at ART initiation: sex (no. = 1), weight (no. = 212), weight-for-age z-score (no. = 231), CD4 cell percentage (no. = 177), CD4 cell count (no. = 215), blood haemoglobin (no. = 216), WHO HIV/AIDS clinical stage (no. = 145).