PROGRESSION OF HIV/AIDS IN CHILDREN ATTENDING AMPATH CLINICS IN W/KENYA

Prof. Ayaya SO, Dr Nyandiko WMDr Vreeman RC, Prof. Rotich JK

IeDEA PI meeting, Zanzibar

BACKGROUND

• AMPATH - 10YRS• Incubation period• AIDS Survival Time• Impact of AMPATH

OBJECTIVES

• Determine the incubation period and its associated factors

• Determine AIDS Survival Time and its associated factors

METHODOLOGY

• Study subjects : HIV infected children aged 14 yrs and below

• Setting: AMPATH clinics in WESTERN Kenya• Design : retrospective analysis of prospectively

collected data• Analysis : regression analysis and Kaplan Meier

Survival Curves

RESULTS IDemographic data

• Total of 5792 children included• Age ≤ 2 yrs 1093 (19%)• Female sex 2954 (51%)• Ever on ARVs 3232 (56%)• Orphans 1702 (29.39%)

RESULTS II

AT ENROLMENT:• HAZ severe (<3SD) 1230 (33.27%)• WAZ severe(<3SD) 808 (21.64%)• CDC class C 1134(19.92%)• AIDS 3630(62.67%)

RESULTS III

ADHERENCE• Perfect ARV adherence 2271(68.82%)• Perfect clinic adherence 1435(26.34%)

RESULTS IV

OUTCOMES• Time from diagnosis to ADE : Mean 217 days Median 112 days• Time from ADE to death/LTFU Mean 201 DAYS Median 117 days

RESULTS V

• Factors associated with incubation period(HIV to ADE) AGE ≤ 2 YRS

CDC stage at diagnosis (HR=1.8, CI 1.05-2.45) Non-clinic adherence (HR=0.9, CI 1.05-2.45) Never on ARV (HR=.41, CI 0.27-0.62)

RESULTS VI

FACTORS ASSOCIATED WITH HIV TO ADE > 2 YRS

CD4% at diagnosis (HR=0.9, CI .93-.95) CDC stage C at diagnosis(HR=5.4, CI 3.98-7.22) Non MTRH CLINIC (hr=.8, CI .66-.94) Never on ARV (HR=.36, CI .29-.66)

RESULTS VII

Factors associated with HIV to ADE age ≤ 2 yrs

CD 4% at diagnosis CDC at diagnosis Non-clinic adherence(HR=1.6, CI 1.05-2.45) Never on ARV (HR=0.41, CI .27-.62)

RESULTS VIII

• FACTORS ASSOCIATED WITH AIDS SURVIVAL TIME (age ≤ 2 yrs)

Nearest CD4 at ADE ) EVER ON ARV )(HR=9.2, CI 3.9-21.1)

RESULTS IX

FACTORS ASSOCIATED WITH AIDS SURVIVAL TIME (age ≥ 2yrs)

• Nearest CD 4 at ADE) ( HR=7.3, CI 4.1-13)• Ever on ARV )

CONCLUSIONS I

• Incubation period was short• AIDS survival time was short• Factors associated with incubation period were: CDC stage at diagnosis Non- clinic adherence never on ARV

CONCLUSIONS II

CD 4% Non MTRH clinic• Factors associated with AIDS Survival time

were: Nearest CD4 to ADE Ever on ARV

ACKNOWLEDGEMENTS

• Dean SOM MU• Dean IUMC• USAID-AMPATH• MU-IU PRWG• IEDEA EA• JOE MAMLIN