title: Evaluation of parent-child pairs on antiretroviral therapy in separate adult and pediatric clinics.
abstract: In Africa, HIV infection is considered a family disease. A retrospective cohort analysis was performed to describe the characteristics and outcome in 35 parent-child pairs taking antiretroviral therapy (ART) in separate adult and pediatric HIV clinics. In 26 pairs, ART was first initiated in children. Baseline median CD4 count was 122/mm(3) in adults and 376/mm(3) in children. World Health Organization stage 3 or 4 disease affected 49% of adults and 83% of children. In all, 3 parents and 1 child died. Hospitalization, poor adherence, missed appointments, or regimen change affected >50% of pairs on ART. Following tuberculosis diagnosis in their parents, 2 of the 5 children were not investigated. By week 104, 29 (83%) pairs remained on ART, and 69% of patients on ART were virologically suppressed. Parent-child pairs with advanced HIV infection had good outcomes when cared for in separate clinics. Establishing lines of communication between clinics is important. Family-centered services may provide more integrated care.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Bost
authors.affiliation: Faculty of Health Sciences, Wits Reproductive Health and HIV Research Institute, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Lee
authors.initials: L
authors.lastname: Fairlie
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa karstaedt@mweb.co.za.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Karstaedt
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010290:Parents; D010349:Patient Compliance; D010372:Pediatrics; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
keywords: Africa; HIV; antiretroviral treatment outcomes; children; parents