Department of Medicine, Chris Hani Baragwanath Hospital, University of the Witwatersrand, PO Box 128, Parklands, Johannesburg, South Africa; Faculty of Health Sciences, Wits Reproductive Health and HIV Research Institute, University of the Witwatersrand, Johannesburg, South Africa
Bost, B.P., Department of Medicine, Chris Hani Baragwanath Hospital, University of the Witwatersrand, PO Box 128, Parklands, Johannesburg, South Africa; Fairlie, L., Faculty of Health Sciences, Wits Reproductive Health and HIV Research Institute, University of the Witwatersrand, Johannesburg, South Africa; Karstaedt, A.S., Department of Medicine, Chris Hani Baragwanath Hospital, University of the Witwatersrand, PO Box 128, Parklands, Johannesburg, South Africa
In Africa, HIV infection is considered a family disease. A retrospective cohort analysis was performed to describe the characteristics and outcome in 35 parent-child pairs taking antiretroviral therapy (ART) in separate adult and pediatric HIV clinics. In 26 pairs, ART was first initiated in children. Baseline median CD4 count was 122/mm3 in adults and 376/mm3 in children. World Health Organization stage 3 or 4 disease affected 49% of adults and 83% of children. In all, 3 parents and 1 child died. Hospitalization, poor adherence, missed appointments, or regimen change affected >50% of pairs on ART. Following tuberculosis diagnosis in their parents, 2 of the 5 children were not investigated. By week 104, 29 (83%) pairs remained on ART, and 69% of patients on ART were virologically suppressed. Parent-child pairs with advanced HIV infection had good outcomes when cared for in separate clinics. Establishing lines of communication between clinics is important. Family-centered services may provide more integrated care. © The Author(s) 2013.
antiretrovirus agent; efavirenz; lamivudine; stavudine; zidovudine; antiretrovirus agent; adult; Africa; Article; child; cohort analysis; female; hospitalization; human; Human immunodeficiency virus infection; major clinical study; male; parent; patient care; patient compliance; pediatric hospital; treatment outcome; tuberculosis; CD4 lymphocyte count; HIV Infections; immunology; infant; middle aged; outpatient department; pediatrics; preschool child; retrospective study; young adult; Adult; Ambulatory Care Facilities; Anti-Retroviral Agents; CD4 Lymphocyte Count; Child; Child, Preschool; Female; HIV Infections; Hospitalization; Humans; Infant; Male; Middle Aged; Parents; Patient Compliance; Pediatrics; Retrospective Studies; Treatment Outcome; Young Adult