dc.contributor.author |
Jackson, Christi
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dc.contributor.author |
Rehman, Andrea M.
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|
dc.contributor.author |
McHugh, Grace
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dc.contributor.author |
Gonzalez‑Martinez, Carmen
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dc.contributor.author |
Ngwira, Lucky G.
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dc.contributor.author |
Bandason, Tsitsi
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dc.contributor.author |
Mujuru, Hilda
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dc.contributor.author |
Odland, Jon Oyvind
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dc.contributor.author |
Corbett, Elizabeth L.
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dc.contributor.author |
Ferrand, Rashida A.
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dc.contributor.author |
Simms, Victoria
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dc.date.accessioned |
2022-07-25T12:57:56Z |
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dc.date.available |
2022-07-25T12:57:56Z |
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dc.date.issued |
2022-06 |
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dc.description.abstract |
BACKGROUND: We investigated risk factors for sustained virological non-suppression (viral load≥1000 copies/ml on two tests 48 weeks apart) among children and adolescents accessing HIV care in public sector clinics in Harare, Zimbabwe and Blantyre, Malawi. METHODS: Participants were enrolled between 2016 and 2019, were aged 6–19 years, living with HIV, had chronic lung disease (FEV z-score< -1) and had taken antiretroviral therapy (ART) for at least six months. We used multivariate logistic regression to identify risk factors for virological non-suppression after 48 weeks, among participants who were non-suppressed at enrolment. RESULTS: At enrolment 258 participants (64.6%) were on frst-line ART and 152/347 (43.8%) had virological non-sup‑ pression. After 48 weeks 114/313 (36.4%) were non-suppressed. Participants non-suppressed at baseline had almost ten times higher odds of non-suppression at follow-up (OR=9.9, 95%CI 5.3–18.4, p<0.001). Of those who were nonsuppressed at enrolment, 87/136 (64.0%) were still non-suppressed at 48 weeks. Among this group non-suppression at 48 weeks was associated with not switching ART regimen (adjusted OR=5.55; 95%CI 1.41–21.83); p=0.014) and with older age. Twelve participants switched regimen in Zimbabwe and none in Malawi. CONCLUSION: Viral non-suppression was high among this group and many with high viral load were not switched to a new regimen, resulting in continued non-suppression after 48 weeks. Further research could determine whether improved adherence counselling and training clinicians on regimen switches can improve viral suppression rates in this population. |
en_US |
dc.description.department |
School of Health Systems and Public Health (SHSPH) |
en_US |
dc.description.sponsorship |
Norwegian Research Council, UK Medical Research Council, UK Foreign, Commonwealth and Development Office. |
en_US |
dc.description.uri |
http://www.biomedcentral.com/bmcpediatr |
en_US |
dc.identifier.citation |
Jackson, C., Rehman, A.M., McHugh, G., Gonzalez-Martinez, C., Ngwira, L.G., Bandason, T., Mujuru, H., Odland, J.O., Corbett, E.L., Ferrand, R.A. & Simms, V. Risk factors for sustained virological non-suppression among children and adolescents living with HIV in Zimbabwe and Malawi: a secondary data analysis. BMC Pediatrics 2022 Jun 11;22(1):340. doi: 10.1186/s12887-022-03400-4. |
en_US |
dc.identifier.issn |
1471-2431 (online) |
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dc.identifier.other |
10.1186/s12887-022-03400-4 |
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dc.identifier.uri |
https://repository.up.ac.za/handle/2263/86439 |
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dc.language.iso |
en |
en_US |
dc.publisher |
BMC |
en_US |
dc.rights |
© The Author(s) 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License. |
en_US |
dc.subject |
Adolescent |
en_US |
dc.subject |
Antiretroviral therapy |
en_US |
dc.subject |
Chronic lung disease |
en_US |
dc.subject |
HIV viral load |
en_US |
dc.subject |
Resistance |
en_US |
dc.subject |
Viral non-suppression |
en_US |
dc.subject |
Human immunodeficiency virus (HIV) |
en_US |
dc.title |
Risk factors for sustained virological non-suppression among children and adolescents living with HIV in Zimbabwe and Malawi : a secondary data analysis |
en_US |
dc.type |
Article |
en_US |