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PROGRESSION OF HIV/AIDS IN CHILDREN ATTENDING AMPATH CLINICS IN W/KENYA

PROGRESSION OF HIV/AIDS IN CHILDREN ATTENDING AMPATH CLINICS IN W/KENYA. Prof. Ayaya SO, Dr Nyandiko WM Dr Vreeman RC, Prof. Rotich JK IeDEA PI meeting, Zanzibar. BACKGROUND. AMPATH - 10YRS Incubation period AIDS Survival Time Impact of AMPATH. OBJECTIVES.

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PROGRESSION OF HIV/AIDS IN CHILDREN ATTENDING AMPATH CLINICS IN W/KENYA

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  1. PROGRESSION OF HIV/AIDS IN CHILDREN ATTENDING AMPATH CLINICS IN W/KENYA Prof. Ayaya SO, Dr Nyandiko WM Dr Vreeman RC, Prof. Rotich JK IeDEA PI meeting, Zanzibar

  2. BACKGROUND • AMPATH - 10YRS • Incubation period • AIDS Survival Time • Impact of AMPATH

  3. OBJECTIVES • Determine the incubation period and its associated factors • Determine AIDS Survival Time and its associated factors

  4. METHODOLOGY • Study subjects : HIV infected children aged 14 yrs and below • Setting: AMPATH clinics in WESTERN Kenya • Design : retrospective analysis of prospectively collected data • Analysis : regression analysis and Kaplan Meier Survival Curves

  5. RESULTS IDemographic data • Total of 5792 children included • Age ≤ 2 yrs 1093 (19%) • Female sex 2954 (51%) • Ever on ARVs 3232 (56%) • Orphans 1702 (29.39%)

  6. RESULTS II AT ENROLMENT: • HAZ severe (<3SD) 1230 (33.27%) • WAZ severe(<3SD) 808 (21.64%) • CDC class C 1134(19.92%) • AIDS 3630(62.67%)

  7. RESULTS III ADHERENCE • Perfect ARV adherence 2271(68.82%) • Perfect clinic adherence 1435(26.34%)

  8. RESULTS IV OUTCOMES • Time from diagnosis to ADE : Mean 217 days Median 112 days • Time from ADE to death/LTFU Mean 201 DAYS Median 117 days

  9. RESULTS V • Factors associated with incubation period(HIV to ADE) AGE ≤ 2 YRS CDC stage at diagnosis (HR=1.8, CI 1.05-2.45) Non-clinic adherence (HR=0.9, CI 1.05-2.45) Never on ARV (HR=.41, CI 0.27-0.62)

  10. RESULTS VI FACTORS ASSOCIATED WITH HIV TO ADE > 2 YRS CD4% at diagnosis (HR=0.9, CI .93-.95) CDC stage C at diagnosis(HR=5.4, CI 3.98-7.22) Non MTRH CLINIC (hr=.8, CI .66-.94) Never on ARV (HR=.36, CI .29-.66)

  11. RESULTS VII Factors associated with HIV to ADE age ≤ 2 yrs CD 4% at diagnosis CDC at diagnosis Non-clinic adherence(HR=1.6, CI 1.05-2.45) Never on ARV (HR=0.41, CI .27-.62)

  12. RESULTS VIII • FACTORS ASSOCIATED WITH AIDS SURVIVAL TIME (age ≤ 2 yrs) Nearest CD4 at ADE ) EVER ON ARV )(HR=9.2, CI 3.9-21.1)

  13. RESULTS IX FACTORS ASSOCIATED WITH AIDS SURVIVAL TIME (age ≥ 2yrs) • Nearest CD 4 at ADE) ( HR=7.3, CI 4.1-13) • Ever on ARV )

  14. CONCLUSIONS I • Incubation period was short • AIDS survival time was short • Factors associated with incubation period were: CDC stage at diagnosis Non- clinic adherence never on ARV

  15. CONCLUSIONS II CD 4% Non MTRH clinic • Factors associated with AIDS Survival time were: Nearest CD4 to ADE Ever on ARV

  16. ACKNOWLEDGEMENTS • Dean SOM MU • Dean IUMC • USAID-AMPATH • MU-IU PRWG • IEDEA EA • JOE MAMLIN

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