SOME FACTORS AFFECTING THE EFFECTIVENESS OF ART TREATMENT IN HIV INFECTED CHILDREN AT VIETNAM NATIONAL CHILDREN’S HOSPITAL
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Abstract
Objective: Analyze some factors affecting the effectiveness of ARV treatment in HIVinfected children at Vietnam National Children’s Hospital from October 2022 to April 2023.
Subjects and methods: tissue research Cross-sectional description of 312 children under 16 years old at the time of diagnosis of HIV infection and registration for ARV treatment at Vietnam National Children’s Hospital from January 1, 2006 to April 30, 2018. Results:Male/female ratio was 1.36/1, average age (15.8 ± 4.1) years old. During treatment: 62/312 (19.9%) children failed frst-line ARV treatment. When starting ARV treatment: 69.6% of children had TCD4 counts at the level of severe immunodefciency, this is considered is a predictor of frst-line ARV treatment failure (OR = 2.15; [95%CI: 1.062 - 4.354], p = 0.031). Some risk factors that affect the effectiveness of frst-line ARV treatment: children have lost one parent or both parents (OR = 2.2; [95%CI: 1.241 - 3.971], p = 0.006), stigma and discrimination (OR = 4.6 [95%CI: 2.07 - 10.086], p = 0.0001), children know they are HIV positive (OR = 3.9; [95%CI: 1.791 - 8.623], p = 0.0001), children feel uncomfortable with HIV infection (OR = 2.4; [95%CI: 1.292 - 4.451], p = 0.005), children take their own medicine (OR = 6.6 [95%CI: 2.006 - 21.88], p = 0.0001); Children drop out of school or do not attend school (OR=2; [95%CI: 0.991- 4.042], p=0.05). Multivariable logistic regression analysis identifed a number of factors for second-line ART failure: children feel uncomfortable with their HIV infection [OR=11.3; 95%CI: 1.455 - 88.054; p=0.02]; children do not know the purpose of ARV treatment [OR=12.8; 95%CI: 1,091 - 150,669; p=0.042].
Conclusion: Factors causing frst-line ARV treatment failure are: Severe immunodefciency when starting ARV treatment, using Stavudine in the ARV treatment regimen, children with one or both parents deceased, children are stigmatized and discriminated against, know they are HIV positive, feel uncomfortable with their HIV infection, drop out of school or do not go to school, and take their own medicine. Factors that cause failure of second-line ARV treatment are: children have difculty adapting, feel uncomfortable with HIV infection, and do not know the purpose of ARV treatment.
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Keywords
HIV, HIV treatment for children, HIV treatment, children, ARV treatment
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