article · Heliyon
Children living with HIV face significant risks from advanced opportunistic infections, even when undergoing antiretroviral therapy. A ten-year retrospective study evaluated 349 children under 15 years of age receiving treatment at two specialised referral hospitals in north-west Ethiopia between 2010 and 2020. The incidence rate of advanced opportunistic infections among these children was 5.53 per 100 person-years of observation, with a median infection-free survival time of 113 months. The analysis established that clinical treatment failure, anaemia defined by haemoglobin levels below 10 mg/dl, non-use of cotrimoxazole preventive therapy, and poor or fair adherence to antiretroviral therapy were significant predictors of shorter infection-free survival. These findings indicate a comparatively high infection rate and highlight the critical role of preventive medication, anaemia management, and consistent treatment adherence in sustaining long-term health outcomes for paediatric HIV patients.
Opportunistic infections remain a major cause of illness and death among children receiving HIV treatment. By identifying clinical risk factors such as anaemia, poor medication adherence, and the absence of preventive therapies, healthcare providers can better target supportive care. Recognising these indicators allows clinicians to address treatable risks early and improve long-term survival for paediatric patients in resource-constrained settings.
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BACKGROUND: This study is aimed to assess the incidence of advanced opportunistic infections (OIs) and its predictors among Human Immunodeficiency Virus (HIV) infected children at Debre Tabor referral Hospital and University of Gondar Compressive specialized Hospitals, Northwest Ethiopia, 2020. METHODS: A retrospective follow-up study was conducted from June 1, 2010, to May 30, 2020. A total of 349 children under the age of 15 who had received Anti-Retroviral Therapy (ART) were included in the study. Data were entered into Epi info version 7.2 and then exported to Stata 14.0 for analysis. Kaplan Meier curve and Log-rank test were used to determine the median survival time and the discrepancy of different categorical variables. The Cox regression model was used to identify the predictors of advanced opportunistic infections. The Adjusted hazard ratio (AHR) at 95% confidence interval (CI) was used to declare statistical significance. RESULT: The incidence rate of advanced opportunistic infection was 5.53 per 100 (95% CI: 4.7, 6.9) Person per year observation (PYO). The median survival time was 113 months and the total follow-up periods were yielding 18882 months. Children presenting with treatment failure, Cotrimoxazole Preventive Therapy (CPT) non-user, low hemoglobin level (<10 mg/dl), and poor/fair level of adherence to ART were less free survival time as compared to their counterparts for advanced opportunistic infections. CONCLUSION: In this study, the median of advanced OIs free survival time was found to be low and the incidence rate was found to be high. The incidence advanced OIs was associated with anemia, treatment failure, and poor/fair level of adherence, cotrimoxazole preventive therapy non-users. Further research should conduct to evaluate and to improve the quality of care in the study area.
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DOI: 10.1016/j.heliyon.2021.e06745
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