Clinical and Immunological Efficacy of Highly Anti Retroviral Therapy on Paediatric Patients at the University of Abuja Teaching Hospital

Abstract

A two year prospective study of children living with HIV/AIDS and on treatment with highly active anti-retroviral therapy (HAART) at the paediatrics out-patients special treatment clinic (POSTC) of the University of Abuja Teaching Hospital (UATH) Gwagwalada, was carried out to determine the clinical and immunological efficacy of HAART after the first 12 months on treatment. One hundred and seventy four patients comprising of 91 (52.3 percent) males and 83 (47.7 percent) females (m:f ratio 1.2:1) who were eligible for treatment, were commenced on HAART. Their mean age (SD) at recruitment was 4.9+1.4 years. The baseline weight of the patients increased by 30.2% from 12.7+ 3.5kg to 18.2 + 3.9kg with a net gain of 5.5kg after one year treatment on HAART. This increase reflects a shift from a baseline growth curve of less than 5th centile for age using the National Center for Health Statistics (NCHS) growth chart at commencement of HAART, to 25th centile value after 12 months of treatment. The mean height and body mass index (BMI) similarly showed remarkable increases from mean recruitment values of 99.2 +24.8cm and 12.5+3.2kg/m2 to 111.9+25.5cm and 18.0+2.7kg/m2respectively. CD4 cell count and its percentage increased from a mean baseline recruitment value of 243 +104.2 cells/ml and 11.7 percent to 788.5+217.0 cells/ml and 28.8 percent respectively after the same duration of HAART. Positive correlations were seen between CD4 cell count and bodyweight (r = 0.64, p < 0.01), and between CD4 cell count and BMI and (r = 0.65, p < 0.01). The result shows effective and good outcome of HAART on paediatric HIV/AIDS patients. From the findings, it is recommended that there should be rapid scale up of HAART for paediatric HIV/AIDS patients across the country.