Evaluation of the effectiveness of antiretroviral therapy on mother-to-child transmission of HIV in children in Yunnan Province,2004-2022 and analysis of influencing factors
Objective To investigate the efficacy and influencing factors of antiretroviral therapy in children who with mother-to-child transmission of human immunodeficiency virus(HIV)in Yunnan Province,and to provide a reference for improving the efficacy.Methods The antiretroviral therapy data of HIV children who infected with mother-to-child transmission in Yunnan province were collected.Descriptive epidemiological methods were used to analyze the basic characteristics of children treated with antiretroviral therapy(ART)for HIV infection,as well as the number and age distribution of children who started ART in different years.The factors influencing the efficacy of ART were analyzed by multivariate logistic regression.Results The number of children with initiation of ART has increased since 2004,and has decreased year by year since 2013.By August 2022,among the 1451 children under treatment in the province,48.45% were male;with current age of 16.4(12.8,18.7)years,age of initiation of ART of 7.0(4.2,9.8)years,8.6(5.5,10.8)years on ART;the interval between diagnosis of HIV/acquired immune deficiency syndrome(AIDS)and initiation of ART was 5.1(0.7,29.5)months;the complete suppression rate of HIV-RNA was 68.16% (989/1451),and the rate of ART failure was 20.68% (300/1451).Univariate analysis showed that the factors influencing ART efficacy were age at ART initiation,time already on ART,time between diagnosis of HIV/AIDS and initiation of ART,current ART regimen,and whether or not the ART regimen had been changed(P<0.05).Multivariate Logistic regression analysis was conducted with the factors with statistical significance in the univariate analysis as independent variables,and the results showed that the influencing factors of ART efficacy were time already on ART,time between diagnosis of HIV/AIDS and initiation of ART,current ART regimen,and whether or not the ART regimen had been changed(P<0.05).Multivariate analysis showed that the influencing factors of HIV-RNA suppression effect were age of initiation of ART,years on treatment,time between diagnosis and Initiation ART,different ART regimens,and change regimens or not.Conclusion It is necessary to focus on early detection,early treatment,standardized treatment and improving the adherence of children with special attention to school-age children and who have changed their regimens,so as to further improve the efficacy of ART in children.
Human immunodeficiency virusAcquired immune deficiency syndromeAntiviral therapyMother-to-child transmissionEffect evaluation
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