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dc.contributor.authorKekitiinwa, Addy
dc.contributor.authorLee, Katherine J.
dc.contributor.authorWalker, Sarah
dc.contributor.authorMaganda, Albert
dc.contributor.authorDoerholt, Katja
dc.contributor.authorKitaka, Sabrina B.
dc.contributor.authorAsiimwe, Alice
dc.contributor.authorJudd, Ali
dc.contributor.authorMusoke, Philippa
dc.contributor.authorGibb, Diana M.
dc.date.accessioned2021-12-15T13:26:13Z
dc.date.available2021-12-15T13:26:13Z
dc.date.issued2008
dc.identifier.citationKekitiinwa, A., Lee, K. J., Walker, A. S., Maganda, A., Doerholt, K., Kitaka, S. B., ... & Gibb, D. M. (2008). Differences in factors associated with initial growth, CD4, and viral load responses to ART in HIV-infected children in Kampala, Uganda, and the United Kingdom/Ireland. JAIDS Journal of Acquired Immune Deficiency Syndromes, 49(4), 384-392.doi: 10.1097/QAI.0b013e31818cdef5en_US
dc.identifier.other10.1097/QAI.0b013e31818cdef5
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/625
dc.description.abstractFew studies have directly compared response to antiretroviral therapy (ART) between children living in well-resourced and resource-limited settings. In resource-limited settings non-HIV contributors could reduce the beneficial effects of ART. We compare predictors of short-term immunological, virological, and growth response to ART in HIV-infected children in the United Kingdom/Ireland and Kampala. Methods: We analyzed prospective cohort data from 54 UK/Irish hospitals (the Collaborative HIV Paediatric Study) and Mulago Hospital, Kampala, Uganda. Six- and 12-month responses are described among children initiating combination ART (≥3 drugs, ≥2 classes). Six months post-ART, predictors of viral load (VL) suppression <400 copies/mL, CD4% increases >10%, and height- and weight-for-age z-score increases ≥+0.5 were investigated using logistic regression.In all, 582 UK/Irish children (76% black African) were younger than 876 Kampala children at ART initiation (median 5.0 vs 7.6 years), with higher CD4% (14%, 8%), lower VL (172,491 and 346,809 copies/mL), and less stunting (−0.8, −2.8) and wasting (−0.6, −2.8). Post-ART, median 12-month changes in the United Kingdom/Ireland and Kampala in CD4% (+12%, +13%) and weight (+0.4, +0.5) were similar, but growth was less in Kampala (+0.20, +0.06, P < 0.001). Younger children in both cohorts had better immunological, weight, and growth responses (all P < 0.001). However, lower pre-ART CD4% predicted better immunological response in the United Kingdom/Ireland but poorer response in Kampala (heterogeneity P = 0.004). Although 70% children in both cohorts had suppressed <400 copies/mL at 6 months, adolescents starting ART in the United Kingdom/Ireland had somewhat poorer VL responses than those in Kampala (P = 0.15). In all, 582 UK/Irish children (76% black African) were younger than 876 Kampala children at ART initiation (median 5.0 vs 7.6 years), with higher CD4% (14%, 8%), lower VL (172,491 and 346,809 copies/mL), and less stunting (−0.8, −2.8) and wasting (−0.6, −2.8). Post-ART, median 12-month changes in the United Kingdom/Ireland and Kampala in CD4% (+12%, +13%) and weight (+0.4, +0.5) were similar, but growth was less in Kampala (+0.20, +0.06, P < 0.001). Younger children in both cohorts had better immunological, weight, and growth responses (all P < 0.001). However, lower pre-ART CD4% predicted better immunological response in the United Kingdom/Ireland but poorer response in Kampala (heterogeneity P = 0.004). Although 70% children in both cohorts had suppressed <400 copies/mL at 6 months, adolescents starting ART in the United Kingdom/Ireland had somewhat poorer VL responses than those in Kampala (P = 0.15).en_US
dc.language.isoenen_US
dc.publisherJAIDS Journal of Acquired Immune Deficiency Syndromesen_US
dc.subjectARTen_US
dc.subjectCD4en_US
dc.subjectChildrenen_US
dc.subjectGrowthen_US
dc.subjectHIV (J Acquir Immune Defic Syndr 2008;49:384–392)en_US
dc.titleDifferences in Factors Associated With Initial Growth, CD4, and Viral Load Responses to ART in HIV-Infected Children in Kampala, Uganda, and the United Kingdom/Irelanden_US
dc.typeArticleen_US


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