TITLE:
Epidemiological, Clinical, Therapeutic and evolutionary Aspects of Children Living with HIV in Guédiawaye, Senegal
AUTHORS:
Jean Baptiste Niokhor Diouf, Ndèye Marème Sougou, Cheikh Tidiane Tall, Mariama Kane, Louis Philippe Sarr, Ousmane Ndiaye
KEYWORDS:
Children, HIV, Guédiawaye, Senegal
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.11 No.4,
December
9,
2021
ABSTRACT: Introduction: HIV infection in children is a major public health
problem. The objective of this study carried out in the paediatric department
of the Centre Hospitalier Roi Baudouin de Guédiawaye, was to evaluate the
epidemiological, clinical, therapeutic and evolutionary aspects of a cohort of
children with HIV over a 15-year period and to determine the factors associated
with discontinuation of treatment and transition to second-line treatment. Patients
and Methods: This was a descriptive and analytical cross-sectional study
from August 2004 to December 2019 at the Centre Hospitalier Roi Baudouin de
Guédiawaye. Through this study, age at diagnosis, current age, gender, orphan
status, therapeutic aspects, status announcement and evolution were evaluated.
A total of 129 patient records were studied over a 15-year period (2004-2019).
HIV-positive children with profile I represented 93.8% and there was a male
predominance with a sex ratio of 1.43. The current mean age of the children was
12.2 ± 4.5 and the median was 14 years. Fatherless and motherless children
represented 24.0% and 20.2%, respectively, while both fatherless and motherless
children represented 11.6%. The mean age at the start of ARV treatment was 7.6
± 4.3 years and the median was 7.5 years. The mean age at the start of second-line
treatment was 13.7 years with a standard deviation of 2.6 while the median was
13 years. AZT + 3TC + NVP was the most commonly used combination (29.5%)
followed by TDF + FTC + NVP (26.2%). The mean age at treatment discontinuation
was 13.3 ± 4.3 years while the median was 15 years. More than half of the
children (57.0%) (N = 69) were aware of their status. Factors associated with
discontinuation were gender (p value = 0.025 and OR = 3.2), orphan status (p
value = 0.027 and OR = 3.0) and follow-up time greater than 10 years (p value =
0.013 and OR = 5.6). The mortality rate was 3.9%. Factors associated with
transition to second-line treatment were year of inclusion (p value = 0.001 and
OR = 15.6), age group (p value = 0.001 and OR = 19.2), orphan status (p value =
0.040 and OR = 2.6), treatment regimen (p value = 0.019 and OR = 5.7), duration
of ARV treatment (p value Conclusion The cohort of HIV-infected children
followed up in Guédiawaye remains dominated by adolescents. Orphan status,
announcement of status and duration of follow-up are associated with transition
to second-line treatment and treatment discontinuation.