title: Directly observed highly active antiretroviral therapy for HIV-infected children in Cambodia.
abstract: Antiretroviral medications are becoming available for HIV-infected children in resource-limited settings. Maryknoll, an international Catholic charity, provided directly observed antiretroviral therapy to HIV-infected children in Phnom Penh, Cambodia. Child care workers administered generic antiretroviral drugs twice daily to children, ensuring adherence. Treatment began with 117 late-stage HIV-infected children; 22 died of AIDS during the first 6 months. The rest were treated for at least 6 months and showed CD4 count increases comparable to those achieved in US and European children. Staffing cost for this program was approximately US $5 per child per month, or 15% more than the price of the medications. Drug toxicities were uncommon and easily managed. Directly observed antiretroviral therapy appears to be a promising, low-cost strategy for ensuring adherent treatment for HIV-infected children in a resource-limited setting.
authors.affiliation: Brown Medical School, Providence, RI, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Myung
authors.forename: David
authors.initials: D
authors.lastname: Pugatch
authors.forename: Mark F
authors.initials: MF
authors.lastname: Brady
authors.forename: Phok
authors.initials: P
authors.lastname: Many
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Harwell
authors.forename: Mark
authors.initials: M
authors.lastname: Lurie
authors.forename: John
authors.initials: J
authors.lastname: Tucker
mesh_terms: D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics; D018791:CD4 Lymphocyte Count; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D023801:Directly Observed Therapy / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome