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13.04.2020

Predictors of Early ART Initiation Among HIV + Infants in Kenya: A Retrospective Review of HITSystem Data from 2013 to 2017

verfasst von: Catherine Wexler, Niaman Nazir, Brad Gautney, May Maloba, Melinda Brown, Kathy Goggin, Raphael Lwembe, Sarah Finocchario-Kessler

Erschienen in: Maternal and Child Health Journal | Ausgabe 6/2020

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Abstract

Objective

Early initiation of antiretroviral therapy (ART, before 12 weeks of age) among infants living with HIV reduces infant mortality and slows disease progression. However, inefficiencies in early infant diagnosis processes prevents timely ART initiation among infants living with HIV in Kenya. This study assesses predictors of early ART initiation among infants living with HIV in Kenya.

Design

We retrospectively reviewed data from 96 infants living with HIV born between January 2013 and June 2017 at 6 Kenyan government hospitals.

Methods

The primary outcome was infant receipt of ART by 12 weeks of age. We assessed bivariable and multivariable predictors of ART initiation by 12 weeks of age.

Results

Among 96 infants living with HIV, 82 (85.4%) infants initiated ART at a median infant age of 17.1 weeks. Of the 82 infants who started ART, only 17 (20.7%) initiated ART by 12 weeks of age. In multivariable logistic regression analyses, testing per national guidelines (< 7 weeks of age) (aOR 40.14 [3.96–406.97], p = 0.002), shorter turnaround time for result notification (≤ 4 weeks) (aOR 11.30 [2.02–63.34], p = 0.006), and ART initiation within 3 days of mother notification (aOR 7.32 [1.41–38.03], p = 0.006) were significantly associated with ART initiation by 12 weeks of age.

Conclusion

Current implementation of early infant diagnosis services in Kenyan only achieves targets for early ART initiation in one-fifth of infants with HIV. Strengthening services to support earlier infant testing and streamlined processes for early infant diagnosis may increase the proportion of infants who receive timely ART.

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Titel: Predictors of Early ART Initiation Among HIV + Infants in Kenya: A Retrospective Review of HITSystem Data from 2013 to 2017
verfasst von: Catherine Wexler
Niaman Nazir
Brad Gautney
May Maloba
Melinda Brown
Kathy Goggin
Raphael Lwembe
Sarah Finocchario-Kessler
Publikationsdatum: 13.04.2020
Verlag: Springer US
Erschienen in: Maternal and Child Health Journal / Ausgabe 6/2020
Print ISSN: 1092-7875
Elektronische ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-020-02909-3

Springer Medizin

Abstract

Objective

Design

Methods

Results

Conclusion

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