ArticleBMC infectious diseases2013
Effectiveness of first-line antiretroviral therapy and correlates of longitudinal changes in CD4 and viral load among HIV-infected children in Ghana.
Article in BMC infectious diseases, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Prevalence and predictors of virological failure in pediatric patients on HAART in sub-Saharan Africa: a systematic review and meta-analysis.The Pan African medical journal · 2023Pooled it
- Choice of initial antiretroviral drugs and treatment outcomes among HIV-infected patients in sub-Saharan Africa: systematic review and meta-analysis of observational studies.Systematic reviews · 2017Pooled it
- Virologic response of treatment experienced HIV-infected Ugandan children and adolescents on NNRTI based first-line regimen, previously monitored without viral load.BMC pediatrics · 2021Trial
- Trial
- Viral suppression status and associated factors among key populations on ART in Western Oromia, Ethiopia: a retrospective analysis.AIDS research and therapy · 2026Article
- Tracking viral control in adolescents on antiretroviral therapy in Lusaka, Zambia: A retrospective cohort analysis.Southern African journal of HIV medicine · 2025Article
- Replicative co-infections with human immunodeficiency virus 1 and 2 as well as hepatitis B and C virus in Ghanaian individuals.European journal of microbiology & immunology · 2024Article
- Characteristics and influencing factors of immunological non-responders in HIV-1-infected patients receiving antiretroviral therapy: a cross-sectional study in Guangxi.Scientific reports · 2024Article
- Predictors of CD4 cell count progression over time among adolescents and young adults transitioning to adult-oriented HIV care in Southern Ethiopia from 2017 to 2021: a retrospective cohort study.BMC public health · 2024Article
- Article
- Factors Affecting Virological Failure in Children Receiving First-Line Antiretroviral Therapy in Ethiopian Healthcare Facilities: A Retrospective Analysis.Pediatric health, medicine and therapeutics · 2024Article
- Article
- Factors associated with viral suppression and rebound among adult HIV patients on treatment: a retrospective study in Ghana.AIDS research and therapy · 2022Review
- Article
- Analysis of the Influencing Factors of Immunological Nonresponders in Wuhan, China.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2022Article
- Determinants of Virological Failure Among HIV-Infected Children on First-Line Antiretroviral Therapy in West Gojjam Zone, Amhara Region, Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Predictors of CD4 count changes over time among children who initiated highly active antiretroviral therapy in Ethiopia.Tropical medicine and health · 2020Article
- Increased Virological Failure and Determinants Among HIV Patients on Highly Active Retroviral Therapy in Adigrat General Hospital, Northern Ethiopia, 2019: Hospital-Based Cross-Sectional Study.Infection and drug resistance · 2020Article
- Unsatisfactory long-term virological suppression in human immunodeficiency virus-infected children in the Amazonas State, Brazil.Revista da Sociedade Brasileira de Medicina Tropical · 2020Article
- Time to First-Line ART Failure and Time to Second-Line ART Switch in the IeDEA Pediatric Cohort.Journal of acquired immune deficiency syndromes (1999) · 2018Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundAntiretroviral therapy (ART) scale-up in resource-limited countries, with limited capacity for CD4 and HIV viral load monitoring, presents a unique challenge. We determined the effectiveness of first-line ART in a real world pediatric HIV clinic and explored associations between readily obtainable patient data and the trajectories of change in CD4 count and HIV viral load.
methodsWe performed a longitudinal study of a cohort of HIV-infected children initiating ART at the Korle-Bu Teaching Hospital Pediatric HIV clinic in Accra, Ghana, aged 0-13 years from 2009-2012. CD4 and viral load testing were done every 4 to 6 months and genotypic resistance testing was performed for children failing therapy. A mixed linear modeling approach, combining fixed and random subject effects, was employed for data analysis.
resultsNinety HIV-infected children aged 0 to 13 years initiating ART were enrolled. The effectiveness of first-line regimen among study participants was 83.3%, based on WHO criteria for virologic failure. Fifteen of the 90 (16.7%) children met the criteria for virologic treatment failure after at least 24 weeks on ART. Sixty-seven percent virologic failures harbored viruses with ≥ 1 drug resistant mutations (DRMs); M184V/K103N was the predominant resistance pathway. Age at initiation of therapy, child's gender, having a parent as a primary care giver, severity of illness, and type of regimen were associated with treatment outcomes.
conclusionsFirst-line ART regimens were effective and well tolerated. We identified predictors of the trajectories of change in CD4 and viral load to inform targeted laboratory monitoring of ART among HIV-infected children in resource-limited countries.
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