A Review of Clinical and Immunological Outcomes as Predictors of Viral Loads Among Children on HAART for at Least 24 Weeks at the University Teaching Hospital, Lusaka, Zambia

Ginwalla, Rokaya K (2011) A Review of Clinical and Immunological Outcomes as Predictors of Viral Loads Among Children on HAART for at Least 24 Weeks at the University Teaching Hospital, Lusaka, Zambia. Masters thesis, University of Zambia.

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Abstract

Title: A review of clinical and immunological outcomes as predictors of viral load response among children on HAART for at least 24 weeks at the University Teaching Hospital, Lusaka, Zambia Authors: Ginwalla R2Chama E1, Kawamya-Banda F1, Thomas R1, Mwiya M1, Kankasa C1. 1. Paediatric Centre of Excellence, University Teaching Hospital 2. University Of Zambia Department of Public Health Objectives: To determine the prevalence of clinical, immunological and virological failure in children on HAART for more than 24 weeks and see how well the clinical, immunological parameters can predict virological response in children HAART at the University Teaching Hospital in Lusaka. Methods: Retrospective chart review of routinely collected patient data from a cohort of HIV positive children and adolescents between 0 to 19 years, who had received ART for more than 24 weeks and had at least one documented viral load test result. For the period September 2005 to August 2011 every second patient file with viral load result was chosen systematically for analysis and data was collected using a form designed to capture every six monthly clinical visit with the corresponding laboratory results. Results: A total of 517 files were reviewed. Clinical parameters (WHO staging, BMI Z-score and hemoglobin were not good predictors of viral load response. Immunological parameter, (CD4 count or age related CD4%), was a good predictor of virological response (p value 0.01 and 95% CI - 0.49 to -0.29). However this prediction was only positive for 68% of patients while the majority with a positive prediction fell in the category where VL <1000, for those with VL > 1000, CD4 criteria was a poor predictor of failure. Conclusions: Routine viral load testing in the HIV treatment program in Zambia will help prevent multiple drug resistance mutations with early appropriate second-line treatment. It will also prevent premature drug changes, thus preserving future option.

Item Type:	Thesis (Masters)
Subjects:	Q Science > QR Microbiology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Africana
Depositing User:	Geoffrey Obatsa
Date Deposited:	27 Jul 2018 13:07
Last Modified:	27 Jul 2018 13:07
URI:	http://thesisbank.jhia.ac.ke/id/eprint/8296

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