title: Impact of orphan status on HIV treatment outcomes and retention in care of children and adolescents in Asia.
abstract: An analysis of the impact of orphanhood at antiretroviral therapy (ART) initiation on HIV outcomes in Asia included 4300 children; 51% were male. At ART initiation, 1805 (42%) were non-orphans (median age: 3 years), 1437 (33%) were single orphans (6 years) and 1058 (25%) were double orphans (7 years). Ten-year post-ART survival was 93.4-95.2% across orphan categories. Clinic transfers were higher among single and double orphans than non-orphans (41%vs11%,P<0.001). On multivariate analysis, children ≥3 years at ART initiation (hazard ratio 1.58vs<3 years, 95% confidence interval: 1.11-2.24) were more likely to be lost to follow-up. Although post-ART mortality and retention did not differ by orphan status, orphans were at greater risk of starting ART at older ages, and with more severe immunosuppression and poorer growth.
authors: Hanoi Medical University , Hanoi , Vietnam.
authors: Bui Vu
authors: BV
authors: Huy
authors: HIV-NAT, The Thai Red Cross AIDS Research Centre , Bangkok , Thailand.
authors: Sirinya
authors: S
authors: Teeraananchai
authors: Worldwide Orphans Foundation , Ho Chi Minh City , Vietnam.
authors: Le Ngoc
authors: LN
authors: Oanh
authors: New Hope for Cambodian Children , Phnom Penh , Cambodia.
authors: John
authors: J
authors: Tucker
authors: Cipto Mangunkusumo - Faculty of Medicine Universitas Indonesia , Jakarta , Indonesia.
authors: Nia
authors: N
authors: Kurniati
authors: Chiangrai Prachanukroh Hospital , Chiang Rai , Thailand.
authors: Rawiwan
authors: R
authors: Hansudewechakul
authors: Children's Hospital 1 , Ho Chi Minh City , Vietnam.
authors: Khanh Huu
authors: KH
authors: Truong
authors: National Centre for HIV/AIDS Dermatology and STDs and University of Health Sciences , Phnom Penh , Cambodia.
authors: Vohith
authors: V
authors: Khol
authors: National Hospital of Pediatrics , Hanoi , Vietnam.
authors: Lam Van
authors: LV
authors: Nguyen
authors: Children's Hospital 2 , Ho Chi Minh City , Vietnam.
authors: Viet
authors: V
authors: Chau Do
authors: Department of Pediatrics, Faculty of Medicine , Khon Kaen University , Khon Kaen , Thailand.
authors: Pagakrong
authors: P
authors: Lumbiganon
authors: Department of Pediatrics, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
authors: Nantaka
authors: N
authors: Kongstan
authors: HIV-NAT, The Thai Red Cross AIDS Research Centre , Bangkok , Thailand.
authors: Torsak
authors: T
authors: Bunupuradah
authors: Department of Pediatrics, Faculty of Medicine , Chiang Mai University and Research Institute for Health Sciences , Chiang Mai , Thailand.
authors: Tavitiya
authors: T
authors: Sudjaritruk
authors: YRGCARE Medical Centre, CART CRS , Chennai , India.
authors: Nagalingeswaran
authors: N
authors: Kumarasamy
authors: Hospital Raja Perempuan Zainab II , Kelantan , Malaysia.
authors: Nik Khairulddin Nik
authors: NK
authors: Yusoff
authors: Pediatric Institute , Hospital Kuala Lumpur , Kuala Lumpur , Malaysia.
authors: Kamarul Azahar
authors: KA
authors: Mohd Razali
authors: Sanglah Hospital , Udayana University , Bali , Indonesia.
authors: Dewi Kumara
authors: DK
authors: Wati
authors: Hospital Likas , Kota Kinabalu , Malaysia.
authors: Moy Siew
authors: MS
authors: Fong
authors: Penang Hospital , Penang , Malaysia.
authors: Revathy
authors: R
authors: Nallusamy
authors: The Kirby Institute , UNSW Australia , Sydney , Australia.
authors: Azar
authors: A
authors: Kariminia
authors: TREAT Asia/amfAR - The Foundation for AIDS Research , Bangkok , Thailand .
authors: Annette H
authors: AH
authors: Sohn
keywords: Asia; HIV; antiretroviral; orphan; paediatric; treatment