title: [Failure of first-line antiretroviral therapy in HIV-infected children in Ouagadougou, Burkina Faso].
abstract: Approximately one-fourth of the estimated 10,000 HIV-infected children in Burkina Faso are undergoing antiretroviral (ARV) therapy. At the Charles de Gaulle Pediatric Hospital Center in Ouagadougou, Burkina Faso, Support for ARV therapy began in July 2003 and a total of 250 children were undergoing treatment in late 2007. The purpose of this retrospective case-control study conducted over a period of 54 months from July 2003 to December 2007 was to investigate cases involving failure of first-line ARV therapy in particular with regard to cause. All patients (n = 32) showing poor virological, immunological, and/or clinical response to ARV therapy were considered as failures and thus included in the case group. The control group (n = 160) consisted of patients with good responses to treatment. Cases and controls were compared using the Chi-square test and odds ratio (OR) technique with a confidence interval at 95%. The failure rate was 12.8%. Failure was significantly correlated with low socioeconomic level (OR = 3), orphan status (OR = 4), age over 10 years (OR = 5), male gender (OR = 3), baseline viral load > or = 1,000,000 copies/mL (OR = 9), and poor compliance (OR = 37). Mortality in children who failed to respond to first-line ARV therapy was 25% due to the unavailability of a national second-line ARV therapy program. This study underlines the need for patient education to promote compliance and for creation of reference centers to prescribe ARV therapy to HIV-infected children including second-line ARV and genotyping.
authors.affiliation: Unité de réanimation, Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle (CHUP-CDG) Ouagadougou, Burkina Faso. kouetafla@yahoo.com
authors.forename: F
authors.initials: F
authors.lastname: Kouéta
authors.forename: D
authors.initials: D
authors.lastname: Yé
authors.forename: A
authors.initials: A
authors.lastname: Zoungrana
authors.forename: A
authors.initials: A
authors.lastname: Sacko
authors.forename: R
authors.initials: R
authors.lastname: Ouédraogo-Traoré
authors.forename: E
authors.initials: E
authors.lastname: Kafando
authors.forename: S
authors.initials: S
authors.lastname: Ouédraogo
mesh_terms: D000367:Age Factors; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D002050:Burkina Faso; D016022:Case-Control Studies; D002648:Child; D054540:Child, Orphaned; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D017211:Treatment Failure; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents