Adherence and effectiveness of antiretroviral therapy in HIV infected children

Abstract

Background: Care for HIV infected individuals has dramatically improved by the use of Highly Active Anti Retroviral Therapy (HAART). Nevertheless, virological failure occurs and is often associated with development of drug resistance. Adherence is a major factor determining virological suppression. Significant improvement in nutritional status is seen after initiation of ART. Objectives: To study the adherence and effectiveness of antiretroviral therapy in terms of clinical and immunological parameters in HIV infected children. Methods: A prospective clinical study conducted from April 2007 to April 2008, of all the newly diagnosed HIV positive children aged 2-15 years, started on ART, after approval from the ethical committee. Results: Adherence was > 95% in 35 cases (89.7%), 80-95% was seen in one case (2.6%) and < 80% in 2 cases (5.1%).The mean weight before ART was 15.54±5.63 kg and after ART was 18.88±5.63 kg, p value < 0.001, which is statistically significant. The mean height before ART was 102.38±18.49 cm which increased to 109.22±17.65 cm, p value < 0.001, which is statistically significant. The mean CD4 count levels increased from 515.23±79.62 to 1199.65±100.31 after ART, with p value < 0.001 which was statistically significant. The mean CD4% increased from 12.56±8.06 to 24.45±5.66, p value < 0.001 which was statistically significant. Conclusion: Adherence to HAART was good, HAART improved the average weight and height gain, and increase in CD4 counts of HIV infected children, thus significantly improving the immunological status and WHO staging.

Keywords

• haart
• adherence
• clinical study