A retrospective case-cohort study comparing treatment outcomes in abacavir versus stavudine containing first line antiretroviral treatment regimens in children <3yrs old, at a paediatric programme based in Soweto, South Africa

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dc.contributor.author Cassim, Haseena
dc.contributor.author Otwombe, Kennedy
dc.contributor.author Lazarus, Erica
dc.contributor.author Liberty, Afaaf
dc.contributor.author Gray, Glenda E.
dc.contributor.author Greeff, O.B.W. (Oppel Bernhardt Wilhelm), 1948-
dc.contributor.author Violari, Avy
dc.date.accessioned 2017-09-11T10:16:29Z
dc.date.available 2017-09-11T10:16:29Z
dc.date.issued 2017-07-07
dc.description S1 Table. Outcomes at 6 and 12 months for those with viral loads above 100 000 copies/ml. en_ZA
dc.description S2 Table. Outcomes at 6 and 12 months for those with viral loads above 100 000 copies/ml. en_ZA
dc.description S1 File. Supporting data. en_ZA
dc.description.abstract INTRODUCTION The current World Health Organization guideline for first line antiretroviral therapy (ART) in HIV-infected children recommends the use of abacavir and lamivudine as nucleoside backbones and no longer includes stavudine. We compared treatment outcomes with abacavir (ABC) versus stavudine (d4T) in a cohort of HIV-1 infected children 6 and 12 months after antiretroviral therapy was initiated. METHODS This was a retrospective case-cohort study, using programmatic data from children enrolled in the Paediatric Wellness Programme at the Perinatal HIV Research Unit in Soweto, South Africa between 2005 and 2013. Children on abacavir/stavudine who had initiated ART at age <3 years with a regimen including lamivudine and lopinavir/ritonavir and had at least one 6 or 12 month viral load result were eligible. All ABC cases identified were matched for age at ART initiation and gender to eligible d4T controls (1:2). Outcomes analysed at 6 and 12 months post ART initiation included virological failure, mortality, immunological failure and anthropometry. Chi-square tests compared categorical measures while Kruskal-Wallis compared continuous measures. RESULTS We identified 57 eligible ABC cases and selected 114 matched d4T controls. Overall, 57% were females and 89% started treatment at age <1year. The median age at ART initiation was 3.11 (IQR: 1.98±6.05) months. There was no difference in the proportion of children virologically suppressed between the groups at 6 (ABC 54.5% vs. d4T 67.0%, p = 0.125) and 12 (ABC 66.7% vs. d4T 71.6%, p = 0.53) months post ART-initiation. The proportion of children with adherence levels >90% for ABC and d4T were similar too (95% in ABC vs. 86% in d4T, p = 0.10). The proportion of children who died over 12 months was 3.5% in the ABC and 7.9% in the d4T group (p = 0.27). Similarly, the anthropometric measures were comparable. CONCLUSIONS It is reassuring that in the short term, in this group of patients, the treatment outcomes were similar. en_ZA
dc.description.department Pharmacology en_ZA
dc.description.librarian am2017 en_ZA
dc.description.sponsorship South Africa Mission of the US Agency for International Development (USAID) [674-A-0 0-08-00009-00]. en_ZA
dc.description.uri http://www.plosone.org en_ZA
dc.identifier.citation Cassim, H., Otwombe, K., Lazarus, E., Liberty, A., Gray, G.E., Greeff, O.B.W. & Violari, A. (2017) A retrospective case-cohort study comparing treatment outcomes in abacavir versus stavudine containing first line antiretroviral treatment regimens in children <3yrs old, at a paediatric programme based in Soweto, South Africa. PLoS ONE 12(7): e0180645. https://DOI.org/ 10.1371/journal.pone.0180645. en_ZA
dc.identifier.issn 1932-6203 (online)
dc.identifier.other 10.1371/journal.pone.0180645
dc.identifier.uri http://hdl.handle.net/2263/62213
dc.language.iso en en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights © 2017 Cassim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License. en_ZA
dc.subject Children en_ZA
dc.subject Antiretroviral therapy (ART) en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject Therapy en_ZA
dc.subject Infants en_ZA
dc.subject Growth en_ZA
dc.subject Abacavir (ABC) en_ZA
dc.subject Stavudine (d4T) en_ZA
dc.subject World Health Organization (WHO) en_ZA
dc.title A retrospective case-cohort study comparing treatment outcomes in abacavir versus stavudine containing first line antiretroviral treatment regimens in children <3yrs old, at a paediatric programme based in Soweto, South Africa en_ZA
dc.type Article en_ZA


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