@article{
 title = {Modelling adverse treatment outcomes of HIV-infected adolescents attending public-sector HIV clinics in Lusaka},
 type = {article},
 year = {2017},
 identifiers = {[object Object]},
 keywords = {Adolescents,Adverse,HIV clinics,HIV-infected,Modelling,Outcomes,Public sector,Treatment},
 volume = {147},
 id = {b8446f73-3948-3d17-af1e-e7a4cf424dba},
 created = {2019-08-19T05:55:46.940Z},
 file_attached = {false},
 profile_id = {bbd10e3a-1136-3ee2-a1df-8395c96e0626},
 last_modified = {2019-08-19T05:55:46.940Z},
 read = {false},
 starred = {false},
 authored = {true},
 confirmed = {false},
 hidden = {false},
 private_publication = {false},
 abstract = {© 2017 The Royal Society for Public Health Background In resource-limited setting, there is scarce evidence comparing antiretroviral therapy (ART) outcomes among HIV-infected adolescents to that of other age groups. Methods and study design We analysed data from 25 ART facilities in Lusaka District, comparing treatment-naïve ART-eligible young adolescents (10–14 years), older adolescents (15–19) and young adults (20–24 years) initiating first-line ART to those aged 24 years or older. The adjusted relative risk (RR) of failure to achieve an adequate CD4 response (defined as failure to increase CD4 count by ≥ 50 cells/mm3 at 6 months or by ≥ 100 cells/mm3) at 6 or 12 months after ART initiation was modelled using log-binomial regression. The effect of age group on mortality and loss to follow-up (LTFUP; ≥60 days since scheduled visit date) was estimated using adjusted Cox proportional hazards models, respectively. This was a routine retrospective design using program data. Results Of the 94,023 patients initiating ART from May 2004 to February 2011, 1303 (1.4%) were young adolescents, 1440 (1.5%) were older adolescents and 5825 (6.2%) were young adults. 85,455 (90.9%) were 24 years or older at the time of ART initiation. Compared with adults, both young adolescents (RR: 0.88, 95% confidence interval [CI]: 0.76–1.01 at 6 months and RR: 0.80, 95% CI: 0.69–0.93 at 12 months) and older adolescents (RR: 0.82, 95% CI: 0.71–0.95 at 6 months) were less likely to achieve adequate CD4 response. No evidence of a difference in mortality risk was observed among older adolescents (hazard ratio [HR] 1.20, 95% CI: 0.93–1.56) compared with adults; however, there was a reduced risk of mortality in young adolescents compared with adults (HR: 0.61, 95% CI: 0.40–0.92). Young adolescents were less likely to be LTFUP following ART initiation (HR: 0.74, 95% CI: 0.59–0.92), while older adolescents and young adults were reported to be more likely to drop out of care (HR: 1.54 95% CI: 1.33–1.78; HR: 1.51 95% CI: 1.40–1.63 respectively). Conclusion Older adolescents and young adults had poorer ART treatment outcomes, including failure to achieve adequate CD4 recovery and failure to remain in long-term care, when compared with adults. Interventions are necessary to help increase outcomes and retention in care.},
 bibtype = {article},
 author = {Fwemba, I. and Musonda, P.},
 journal = {Public Health}
}

{"_id":"RCcpkaabprk5Z8yiD","bibbaseid":"fwemba-musonda-modellingadversetreatmentoutcomesofhivinfectedadolescentsattendingpublicsectorhivclinicsinlusaka-2017","authorIDs":[],"author_short":["Fwemba, I.","Musonda, P."],"bibdata":{"title":"Modelling adverse treatment outcomes of HIV-infected adolescents attending public-sector HIV clinics in Lusaka","type":"article","year":"2017","identifiers":"[object Object]","keywords":"Adolescents,Adverse,HIV clinics,HIV-infected,Modelling,Outcomes,Public sector,Treatment","volume":"147","id":"b8446f73-3948-3d17-af1e-e7a4cf424dba","created":"2019-08-19T05:55:46.940Z","file_attached":false,"profile_id":"bbd10e3a-1136-3ee2-a1df-8395c96e0626","last_modified":"2019-08-19T05:55:46.940Z","read":false,"starred":false,"authored":"true","confirmed":false,"hidden":false,"private_publication":false,"abstract":"© 2017 The Royal Society for Public Health Background In resource-limited setting, there is scarce evidence comparing antiretroviral therapy (ART) outcomes among HIV-infected adolescents to that of other age groups. Methods and study design We analysed data from 25 ART facilities in Lusaka District, comparing treatment-naïve ART-eligible young adolescents (10–14 years), older adolescents (15–19) and young adults (20–24 years) initiating first-line ART to those aged 24 years or older. The adjusted relative risk (RR) of failure to achieve an adequate CD4 response (defined as failure to increase CD4 count by ≥ 50 cells/mm3 at 6 months or by ≥ 100 cells/mm3) at 6 or 12 months after ART initiation was modelled using log-binomial regression. The effect of age group on mortality and loss to follow-up (LTFUP; ≥60 days since scheduled visit date) was estimated using adjusted Cox proportional hazards models, respectively. This was a routine retrospective design using program data. Results Of the 94,023 patients initiating ART from May 2004 to February 2011, 1303 (1.4%) were young adolescents, 1440 (1.5%) were older adolescents and 5825 (6.2%) were young adults. 85,455 (90.9%) were 24 years or older at the time of ART initiation. Compared with adults, both young adolescents (RR: 0.88, 95% confidence interval [CI]: 0.76–1.01 at 6 months and RR: 0.80, 95% CI: 0.69–0.93 at 12 months) and older adolescents (RR: 0.82, 95% CI: 0.71–0.95 at 6 months) were less likely to achieve adequate CD4 response. No evidence of a difference in mortality risk was observed among older adolescents (hazard ratio [HR] 1.20, 95% CI: 0.93–1.56) compared with adults; however, there was a reduced risk of mortality in young adolescents compared with adults (HR: 0.61, 95% CI: 0.40–0.92). Young adolescents were less likely to be LTFUP following ART initiation (HR: 0.74, 95% CI: 0.59–0.92), while older adolescents and young adults were reported to be more likely to drop out of care (HR: 1.54 95% CI: 1.33–1.78; HR: 1.51 95% CI: 1.40–1.63 respectively). Conclusion Older adolescents and young adults had poorer ART treatment outcomes, including failure to achieve adequate CD4 recovery and failure to remain in long-term care, when compared with adults. Interventions are necessary to help increase outcomes and retention in care.","bibtype":"article","author":"Fwemba, I. and Musonda, P.","journal":"Public Health","bibtex":"@article{\n title = {Modelling adverse treatment outcomes of HIV-infected adolescents attending public-sector HIV clinics in Lusaka},\n type = {article},\n year = {2017},\n identifiers = {[object Object]},\n keywords = {Adolescents,Adverse,HIV clinics,HIV-infected,Modelling,Outcomes,Public sector,Treatment},\n volume = {147},\n id = {b8446f73-3948-3d17-af1e-e7a4cf424dba},\n created = {2019-08-19T05:55:46.940Z},\n file_attached = {false},\n profile_id = {bbd10e3a-1136-3ee2-a1df-8395c96e0626},\n last_modified = {2019-08-19T05:55:46.940Z},\n read = {false},\n starred = {false},\n authored = {true},\n confirmed = {false},\n hidden = {false},\n private_publication = {false},\n abstract = {© 2017 The Royal Society for Public Health Background In resource-limited setting, there is scarce evidence comparing antiretroviral therapy (ART) outcomes among HIV-infected adolescents to that of other age groups. Methods and study design We analysed data from 25 ART facilities in Lusaka District, comparing treatment-naïve ART-eligible young adolescents (10–14 years), older adolescents (15–19) and young adults (20–24 years) initiating first-line ART to those aged 24 years or older. The adjusted relative risk (RR) of failure to achieve an adequate CD4 response (defined as failure to increase CD4 count by ≥ 50 cells/mm3 at 6 months or by ≥ 100 cells/mm3) at 6 or 12 months after ART initiation was modelled using log-binomial regression. The effect of age group on mortality and loss to follow-up (LTFUP; ≥60 days since scheduled visit date) was estimated using adjusted Cox proportional hazards models, respectively. This was a routine retrospective design using program data. Results Of the 94,023 patients initiating ART from May 2004 to February 2011, 1303 (1.4%) were young adolescents, 1440 (1.5%) were older adolescents and 5825 (6.2%) were young adults. 85,455 (90.9%) were 24 years or older at the time of ART initiation. Compared with adults, both young adolescents (RR: 0.88, 95% confidence interval [CI]: 0.76–1.01 at 6 months and RR: 0.80, 95% CI: 0.69–0.93 at 12 months) and older adolescents (RR: 0.82, 95% CI: 0.71–0.95 at 6 months) were less likely to achieve adequate CD4 response. No evidence of a difference in mortality risk was observed among older adolescents (hazard ratio [HR] 1.20, 95% CI: 0.93–1.56) compared with adults; however, there was a reduced risk of mortality in young adolescents compared with adults (HR: 0.61, 95% CI: 0.40–0.92). Young adolescents were less likely to be LTFUP following ART initiation (HR: 0.74, 95% CI: 0.59–0.92), while older adolescents and young adults were reported to be more likely to drop out of care (HR: 1.54 95% CI: 1.33–1.78; HR: 1.51 95% CI: 1.40–1.63 respectively). Conclusion Older adolescents and young adults had poorer ART treatment outcomes, including failure to achieve adequate CD4 recovery and failure to remain in long-term care, when compared with adults. Interventions are necessary to help increase outcomes and retention in care.},\n bibtype = {article},\n author = {Fwemba, I. and Musonda, P.},\n journal = {Public Health}\n}","author_short":["Fwemba, I.","Musonda, P."],"bibbaseid":"fwemba-musonda-modellingadversetreatmentoutcomesofhivinfectedadolescentsattendingpublicsectorhivclinicsinlusaka-2017","role":"author","urls":{},"keyword":["Adolescents","Adverse","HIV clinics","HIV-infected","Modelling","Outcomes","Public sector","Treatment"],"downloads":0},"bibtype":"article","creationDate":"2020-01-09T21:47:59.999Z","downloads":0,"keywords":["adolescents","adverse","hiv clinics","hiv-infected","modelling","outcomes","public sector","treatment"],"search_terms":["modelling","adverse","treatment","outcomes","hiv","infected","adolescents","attending","public","sector","hiv","clinics","lusaka","fwemba","musonda"],"title":"Modelling adverse treatment outcomes of HIV-infected adolescents attending public-sector HIV clinics in Lusaka","year":2017}