title: Systematic review of retention of pediatric patients on HIV treatment in low and middle-income countries 2008-2013.
abstract: OBJECTIVE
  There are several published systematic reviews of adult retention in care after antiretroviral therapy (ART) initiation among adults, but limited information on pediatric retention.
  
  
  METHODS
  Systematic review of pediatric retention on ART in low and middle-income countries during 2008-2013.
  
  
  METHODS
  We estimated all-cause attrition (death and loss to follow-up) and retention for pediatric patients receiving first-line ART in routine settings. We searched PubMed, Embase, Cochrane Register, and ISI Web of Science (January 2008-January 2014) and abstracts from AIDS and IAS (2008-2013). We estimated mean retention across cohorts using simple averages; interpolated any time period not reported to, up to the last period reported; summarized total retention in the population using Kaplan-Meier survival curves; and compared pediatric to adult retention.
  
  
  RESULTS
  We found 39 reports of retention in 45 patient cohorts and 55 904 patients in 23 countries. Among them, 37% of patients not retained in care were known to have died and 63% were lost to follow-up. Unweighted averages of reported retention were 85, 81, and 81% at 12, 24, and 36 months after ART initiation. From life-table analysis, we estimated retention at 12, 24, and 36 months at 88, 72, and 67%. We estimated 36-month retention at 66% in Africa and 74% in Asia.
  
  
  CONCLUSIONS
  Pediatric ART retention was similar to that among adults. There were limited data from Asia, only one study from Latin America and the Caribbean, and no data from Eastern Europe, Central Asia, or the Middle East.
authors.affiliation: aCenter for Global Health & Development, Boston University bDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA cHealth Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Fox
authors.forename: Sydney
authors.initials: S
authors.lastname: Rosen
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D059012:Lost to Follow-Up; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents