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Impact of orphan status on HIV treatment outcomes and retention in care of children and adolescents in Asia

Huy BV 1 , Teeraananchai S 2 , Oanh LN 3 , Tucker J 4 , Kurniati N 5 , Hansudewechakul R 6 Show all authors , Truong KH 7 , Khol V 8 , Nguyen LV 9 , Chau Do V 10 , Lumbiganon P 11 , Kongstan N 12 , Bunupuradah T 2 , Sudjaritruk T 13 , Kumarasamy N 14 , Yusoff NK 15 , Mohd Razali KA 16 , Wati DK 17 , Fong MS 18 , Nallusamy R 19 , Kariminia A 20 , Sohn AH 21

Affiliations 

  • 1 Hanoi Medical University , Hanoi , Vietnam
  • 2 HIV-NAT, The Thai Red Cross AIDS Research Centre , Bangkok , Thailand
  • 3 Worldwide Orphans Foundation , Ho Chi Minh City , Vietnam
  • 4 New Hope for Cambodian Children , Phnom Penh , Cambodia
  • 5 Cipto Mangunkusumo - Faculty of Medicine Universitas Indonesia , Jakarta , Indonesia
  • 6 Chiangrai Prachanukroh Hospital , Chiang Rai , Thailand
  • 7 Children's Hospital 1 , Ho Chi Minh City , Vietnam
  • 8 National Centre for HIV/AIDS Dermatology and STDs and University of Health Sciences , Phnom Penh , Cambodia
  • 9 National Hospital of Pediatrics , Hanoi , Vietnam
  • 10 Children's Hospital 2 , Ho Chi Minh City , Vietnam
  • 11 Department of Pediatrics, Faculty of Medicine , Khon Kaen University , Khon Kaen , Thailand
  • 12 Department of Pediatrics, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand
  • 13 Department of Pediatrics, Faculty of Medicine , Chiang Mai University and Research Institute for Health Sciences , Chiang Mai , Thailand
  • 14 YRGCARE Medical Centre, CART CRS , Chennai , India
  • 15 Hospital Raja Perempuan Zainab II , Kelantan , Malaysia
  • 16 Pediatric Institute , Hospital Kuala Lumpur , Kuala Lumpur , Malaysia
  • 17 Sanglah Hospital , Udayana University , Bali , Indonesia
  • 18 Hospital Likas , Kota Kinabalu , Malaysia
  • 19 Penang Hospital , Penang , Malaysia
  • 20 The Kirby Institute , UNSW Australia , Sydney , Australia
  • 21 TREAT Asia/amfAR - The Foundation for AIDS Research , Bangkok , Thailand
Journal of virus eradication, 2016 Oct 05;2(4):227-231.
PMID: 27781105

Abstract

An analysis of the impact of orphanhood at antiretroviral therapy (ART) initiation on HIV outcomes in Asia included 4300 children; 51% were male. At ART initiation, 1805 (42%) were non-orphans (median age: 3 years), 1437 (33%) were single orphans (6 years) and 1058 (25%) were double orphans (7 years). Ten-year post-ART survival was 93.4-95.2% across orphan categories. Clinic transfers were higher among single and double orphans than non-orphans (41% vs 11%, P<0.001). On multivariate analysis, children ≥3 years at ART initiation (hazard ratio 1.58 vs <3 years, 95% confidence interval: 1.11-2.24) were more likely to be lost to follow-up. Although post-ART mortality and retention did not differ by orphan status, orphans were at greater risk of starting ART at older ages, and with more severe immunosuppression and poorer growth.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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