PROGRESSION OF HIV/AIDS IN CHILDREN ATTENDING AMPATH CLINICS IN W/KENYA Prof. Ayaya SO, Dr Nyandiko WM Dr Vreeman RC, Prof. Rotich JK IeDEA PI meeting,

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PROGRESSION OF HIV/AIDS IN CHILDREN ATTENDING AMPATH CLINICS IN W/KENYA Prof. Ayaya SO, Dr Nyandiko WM Dr Vreeman RC, Prof. Rotich JK IeDEA PI meeting, Zanzibar

BACKGROUND AMPATH - 10YRS Incubation period AIDS Survival Time Impact of AMPATH

OBJECTIVES Determine the incubation period and its associated factors Determine AIDS Survival Time and its associated factors

METHODOLOGY Study subjects : HIV infected children aged 14 yrs and below Setting: AMPATH clinics in WESTERN Kenya Design : retrospective analysis of prospectively collected data Analysis : regression analysis and Kaplan Meier Survival Curves

RESULTS I Demographic data Total of 5792 children included Age ≤ 2 yrs 1093 (19%) Female sex 2954 (51%) Ever on ARVs 3232 (56%) Orphans 1702 (29.39%)

RESULTS II AT ENROLMENT: HAZ severe (<3SD) 1230 (33.27%) WAZ severe(<3SD) 808 (21.64%) CDC class C 1134(19.92%) AIDS 3630(62.67%)

RESULTS III ADHERENCE Perfect ARV adherence 2271(68.82%) Perfect clinic adherence 1435(26.34%)

RESULTS IV OUTCOMES Time from diagnosis to ADE : Mean 217 days Median 112 days Time from ADE to death/LTFU Mean 201 DAYS Median 117 days

RESULTS V Factors associated with incubation period(HIV to ADE) AGE ≤ 2 YRS CDC stage at diagnosis (HR=1.8, CI ) Non-clinic adherence (HR=0.9, CI ) Never on ARV (HR=.41, CI )

RESULTS VI FACTORS ASSOCIATED WITH HIV TO ADE > 2 YRS CD4% at diagnosis (HR=0.9, CI ) CDC stage C at diagnosis(HR=5.4, CI ) Non MTRH CLINIC (hr=.8, CI ) Never on ARV (HR=.36, CI )

RESULTS VII Factors associated with HIV to ADE age ≤ 2 yrs CD 4% at diagnosis CDC at diagnosis Non-clinic adherence(HR=1.6, CI ) Never on ARV (HR=0.41, CI )

RESULTS VIII FACTORS ASSOCIATED WITH AIDS SURVIVAL TIME (age ≤ 2 yrs) Nearest CD4 at ADE ) EVER ON ARV )(HR=9.2, CI )

RESULTS IX FACTORS ASSOCIATED WITH AIDS SURVIVAL TIME (age ≥ 2yrs) Nearest CD 4 at ADE) ( HR=7.3, CI ) Ever on ARV )

CONCLUSIONS I Incubation period was short AIDS survival time was short Factors associated with incubation period were: CDC stage at diagnosis Non- clinic adherence never on ARV

CONCLUSIONS II CD 4% Non MTRH clinic Factors associated with AIDS Survival time were: Nearest CD4 to ADE Ever on ARV

ACKNOWLEDGEMENTS Dean SOM MU Dean IUMC USAID-AMPATH MU-IU PRWG IEDEA EA JOE MAMLIN