Nutritional Status of HIV Clients Receiving HAART: Its Implication on Occurrence of Opportunistic Infection

Hussen, Sadikalmahdi; Belachew, Tefera; Hussein, Nezif

doi:10.2174/1874944501710010208

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…However, paediatric patients with malnutrition had extremely high risk of having opportunistic infections (AHR=15.92, 95% CI [5.34-47.50])), similar to studies in Ethiopia (27), Nigeria (26) and…”

Section: Discussionsupporting

confidence: 80%

Abacavir versus Zidovudine-Based Regimens for treatment of HIV-Infected Children in resource limited settings: A Retrospective Cohort Study

Mega

Usamo

Negera

2020

Preprint

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BackgroundAbacavir (ABC) and Zidovudine(AZT) based regimens are the preferred first line nucleoside reverse transcriptase (NRTIs) backbones being widely utilized for managing HIV infection in children. However, there is a dearth of data regarding the clinical outcomes and associated risk factors in Ethiopia. We compared the proportion of mortality and the rate of occurrence of Opportunistic Infections (OIs) with ABC versus AZT based regimens in a cohort of HIV-infected children. MethodsA 42 months retrospective cohort study was conducted. A total of 179 records were reviewed by including data from October 2014 to April 2017. Data were collected on socio-demographic, clinical characteristics of patients and drug related variables. Data were analyzed using STATA13.1. Kaplan-Meier and Cox regression were used to compare survival experience and identify independent predictors. Propensity score matching analysis was conducted to elucidate the average treatment effects of each regimen over OIs.ResultOf 179 patients, 98 (54.7%) were females. The mean (+SD) age of the study subjects was 6.53 ± 2.83 years. Through 42 months analysis, a total of 4 patients (1 (1.14%) from ABC group and 3 (3.3%) from AZT group (p=0.339)) were died. The incidence of opportunistic infections attributed to ABC group was 8.77/100,000 person years (py) and that of AZT was 6.9/100,000py. The incidence rate ratio (IRR) for OIs was (IRR=0.87, 95% CI [0.49-1.53] (p=0.304). Baseline CD4 count (AHR= 0.99, 95% CI [0.98-0.99]), Severe acute malnutrition AHR=15.92, 95% CI [5.34-47.50], and exposure to tuberculosis treatment (AHR=2.93, 95% CI [1.39-6.17]) were the independent predictors for the development of OIs. ConclusionABC and AZT based ART regimens seem to have comparable survival benefit among HIV-infected children in Ethiopia. Therefore, both regimens might be used as an alternative in resource limited settings.

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Section: Discussionsupporting

confidence: 80%

Abacavir versus Zidovudine-Based Regimens for treatment of HIV-Infected Children in resource limited settings: A Retrospective Cohort Study

Mega

Usamo

Negera

2020

Preprint

View full text Add to dashboard Cite

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“…However, paediatric patients with malnutrition had extremely high risk of having opportunistic infections (AHR = 15.92, 95% CI [5.34-47.50]), similar to studies in Ethiopia [28], Nigeria [27] and Cambodia [29]. Malnutrition aggravates the underlying immunosuppression enhancing their susceptibility to various opportunistic infections and HIV disease progression [30,31].…”

Section: Discussionsupporting

confidence: 67%

Abacavir versus Zidovudine-based regimens for treatment of HIV-infected children in resource limited settings: a retrospective cohort study

2020

View full text Add to dashboard Cite

Background: Abacavir (ABC) and Zidovudine (AZT) based regimens are the preferred first line nucleoside reverse transcriptase (NRTIs) backbones being widely utilized for managing HIV infection in children. However, there is a dearth of data regarding the clinical outcomes and associated risk factors in Ethiopia. We compared the proportion of mortality and the rate of occurrence of Opportunistic Infections (OIs) with ABC versus AZT-based regimens in a cohort of HIV-infected children. Methods: A 42 months retrospective cohort study was conducted. A total of 179 records were reviewed by including data from October 2014 to April 2017. Data were collected on socio-demographic, clinical characteristics of patients and drug related variables. Data were analyzed using STATA13.1. Kaplan-Meier and Cox regression were used to compare survival experience and identify independent predictors. Propensity score matching analysis was conducted to elucidate the average treatment effects of each regimen over OIs. Result: Of 179 patients, 98 (54.7%) were females. The mean (+SD) age of the study subjects was 6.53 ± 2.83 years. Through 42 months analysis, a total of 4 patients (1 (1.14%) from ABC group and 3 (3.3%) from AZT group (p = 0.339)) were died. The incidence of opportunistic infections attributed to ABC group was 8.77/100,000 person years (py) and that of AZT was 6.9/100,000py. The incidence rate ratio (IRR) for OIs was (IRR = 0.87, 95% CI [0.49-1.53] (p = 0.304). Baseline CD4 count (AHR = 0.99, 95% CI [0.98-0.99]), Severe acute malnutrition (AHR = 15.92, 95% CI [5.34-47.50]), and exposure to tuberculosis treatment (AHR = 2.93, 95% CI [1.39-6.17]) were the independent predictors for the development of OIs. Conclusion: ABC and AZT based ART regimens seem to have comparable survival benefit among HIV-infected children in Ethiopia. Therefore, both regimens might be used as an alternative in resource limited settings.

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“…8 It will decrease adherence to ART, reduce effectiveness of ART, increase risk of opportunistic infections, facilitate HIV progression and shorten survival. 18,19 Thus, among children with SAM, the risk of death is three to four times higher in HIV-infected children. 20,21 Improving nutritional status is a key strategy to reduce this increased risk of death and to prolong survival of HIVinfected children.…”

Section: Introductionmentioning

confidence: 99%

<p>Determinants of Severe Acute Malnutrition Among HIV-positive Children Receiving HAART in Public Health Institutions of North Wollo Zone, Northeastern Ethiopia: Unmatched Case–Control Study</p>

Bimerew¹,

Teshome²,

Abebe³

et al. 2020

PHMT

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Background Over half of the children living with HIV/AIDS suffer from severe acute malnutrition especially in countries having food insecurity like Ethiopia. However, determinants of severe acute malnutrition among HIV-positive children receiving care and treatment in antiretroviral therapy clinics in Ethiopia are not abundantly investigated. The aim of this study was to assess the determinants of severe acute malnutrition among HIV-positive children receiving highly active antiretroviral therapy in public health institutions of the North Wollo Zone, Northeastern Ethiopia. Methods An institutional-based unmatched case–control study was conducted on 204 under-fifteen, HIV-positive children (68 cases and 136 controls). The data were collected by reviewing medical records and by interviewing attendants. Binary and multiple logistic regressions were employed, and odds ratio with 95%CI was used to interpret results. A p -value of <0.05 was considered as a significant difference between cases and controls for the exposure variable of interest. Results A total of 204 under-fifteen, HIV-positive children were included in this study. Of them, 49.5% were males. About 79.4% of those children had acquired HIV infection through vertical transmission. Poor adherence to ART Adj-OR: 5.72 (1.08–30.27), duration on ART Adj-OR: 5.54 (1.44–21.24), severe immunodeficiency Adj-OR: 6.41 (1.09–37.86), advanced WHO clinical stage Adj-OR: 3.58 (1.03–12.43), oropharyngeal disease Adj-OR: 4.72 (1.13–19.73) and chronic diarrhea Adj-OR: 3.98 (1.05–15.04) were identified to be determinants of SAM in those children. Conclusion Determinant factors for SAM among HIV-positive children were chronic diarrhea, severe immunodeficiency, duration and adherence to ART, oropharyngeal disease and advanced WHO clinical stage. Therefore, it is better if interventions are developed and implemented to address these identified factors.

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Nutritional Status of HIV Clients Receiving HAART: Its Implication on Occurrence of Opportunistic Infection

Cited by 8 publications

References 15 publications

Abacavir versus Zidovudine-Based Regimens for treatment of HIV-Infected Children in resource limited settings: A Retrospective Cohort Study

Abacavir versus Zidovudine-Based Regimens for treatment of HIV-Infected Children in resource limited settings: A Retrospective Cohort Study

Abacavir versus Zidovudine-based regimens for treatment of HIV-infected children in resource limited settings: a retrospective cohort study

<p>Determinants of Severe Acute Malnutrition Among HIV-positive Children Receiving HAART in Public Health Institutions of North Wollo Zone, Northeastern Ethiopia: Unmatched Case–Control Study</p>

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