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Member Research & Reports

Member Research & Reports

BU Study Says More Efforts Needed to Keep Children in HIV Treatment

Rates of retention in care for children receiving HIV treatment in low- and middle-income countries are similar to those for adults, but more interventions are needed to reduce attrition in pediatric care, a new study from Boston University School of Public Health (BUSPH) researchers says.

In the first-ever systematic review of pediatric retention—including more than three dozen studies on antiretroviral therapy in 23 countries and more than 55,000 pediatric patients — researchers Dr. Matthew Fox, associate professor of epidemiology, and Ms. Sydney Rosen, research professor of global health, estimated that overall, average retention in care was 88 percent after 12 months, 72 percent after 24 months, and 67 percent after 36 months. The 36-month retention rates were higher in Asia (74 percent) than in Africa (66 percent). The review covered 2008 through 2013.

Rates for children continuing in antiretroviral therapy (ART) were similar to those for adults — 83 percent after one year, 74 percent after two years, and 68 after three years. Still, the authors said, the numbers of children who do not continue with long-term treatment were troubling.

“The high rate of attrition seen in pediatric cohorts is concerning given that pediatric disease progression tends to occur faster than for adults in the absence of treatment, and therefore likely means that the distribution of mortality among those lost may be higher than in adults,” they said in the study, published in the journal AIDS. “Interventions to reduce attrition from pediatric care are urgently needed, as are studies that trace the true outcomes of lost pediatric patients.”

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