Advanced HIV Disease at Antiretroviral Therapy Initiation and Treatment Outcomes Among Children and Adolescents Compared to Adults Living With HIV in Kinshasa, Democratic Republic of the Congo

被引：3

作者：

Chabikuli, Otto Nzapfurundi ^{[1
,2
]}

Ditekemena, John D. ^{[3
,4
]}

Sigwadhi, Lovemore Nyasha ^{[5
]}

Mulenga, Astrid ^{[3
]}

Mboyo, Aime ^{[6
]}

Bidashimwa, Dieudonne ^{[1
,13
]}

Nachega, Jean B. ^{[7
,8
,9
,10
,11
,12
]}

机构：

[1] Family Hlth Int FHI 360, Durham, NC USA

[2] Howard Univ, Grad Sch, Publ Hlth Program, Washington, DC USA

[3] Family Hlth Int FHI 360, Kinshasa, DEM REP CONGO

[4] Univ Kinshasa, Kinshasa Sch Publ Hlth, Kinshasa, DEM REP CONGO

[5] Stellenbosch Univ, Dept Global Hlth, Div Epidemiol & Biostat, Fac Med & Hlth Sci, Cape Town, Western Cape, South Africa

[6] Natl AIDS Control Program, Kinshasa, DEM REP CONGO

[7] Univ Pittsburgh, Dept Epidemiol, Sch Publ Hlth, Pittsburgh, PA USA

[8] Univ Pittsburgh, Dept Infect Dis & Microbiol, Sch Publ Hlth, Pittsburgh, PA USA

[9] Univ Pittsburgh, Ctr Global Hlth, Sch Publ Hlth, Pittsburgh, PA USA

[10] Johns Hopkins Univ Baltimore, Ctr Global Hlth, Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

[11] Johns Hopkins Univ, Ctr Global Hlth, Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA

[12] Stellenbosch Univ, Dept Med, Div Infect Dis, Fac Med & Hlth Sci, Cape Town, South Africa

[13] Family Hlth Int, FHI 360,359 Blackwell St,Suite 200, Durham, NC 27701 USA

来源：

JOURNAL OF THE INTERNATIONAL ASSOCIATION OF PROVIDERS OF AIDS CARE | 2023年 / 22卷

基金：

美国国家卫生研究院;

关键词：

HIV; CD4; trend; adults; children; adolescents; DRC; ‌; SUB-SAHARAN AFRICA; CARE;

D O I：

10.1177/23259582231221955

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: Little is known about advanced HIV disease (AHD) at antiretroviral therapy (ART) initiation among children and adolescents living with HIV (CALHIV) and related age disparities in the Democratic Republic of the Congo (DRC). Methods: We conducted a retrospective cohort analysis of routine program data collected among adults, adolescents, and children living with HIV in 6 health zones in Kinshasa, DRC from 2005 to 2020. Results: Thirty-two percent of those who initiated ART had AHD. Compared to adults, adolescents had a 15% higher risk of AHD (RR: 1.15; 95% CI: 1.08-1.21; P < .001). Despite their higher risk of AHD, adolescents had a lower risk of mortality (aSHR: 0.72; 95% CI: 0.52-0.99; P = .047) and lower cumulative death events versus adults (aSHR: 0.44; 95% CI: 0.34-0.59; P < .001). Conclusions: ADH at ART initiation is highly prevalent in Kinshasa, DRC, and adolescents are disproportionally impacted. There is a need to scale up high-impact HIV interventions targeting CALHIV.

引用

页数：10

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