Baseline clinical and immunological characteristics of pediatric antiretroviral (ART) patients in Vietnam, 2006-2010

Abstract

Purpose of the study: The PMTCT and pediatric ART programs in Vietnam started in 2005 and pediatric ART has expanded to 42/63 (67%) provinces with over 3,300 children currently receiving ART. National care and treatment guidelines were revised in August 2009 and again in January 2011 to recommend immediate ART for children Method: A retrospective cohort study was conducted between May - July 2011 at 20 pediatric HIV clinics. Data were abstracted from medical records of children initiating ART during January 2006 - December 2010. Summary of results: Mean age at ART initiation among 2,362 children was 4.4 years, and 52% of children were male. The mean proportion with baseline WHO clinical stage 3-4 was 43%, with no reduction over time (p>0.05, Chi square for trend). Mean weight for height z-score was -0.9. Mean CD4% was 11.9%, and this increased from 10.3% in 2006 to 13.4% in 2010 (p Conclusion: Baseline CD4% at ART initiation increased with program expansion. Among children aged <1, there was no significant increase in ART initiation and no change in baseline CD4% or clinical stage. Earlier identification of infected children, linkages to care, and earlier ART initiation are critical to improving outcomes for HIV-infected children in Vietnam.