Antiretroviral Therapy in Infants in Anambra Hospital, Aroma

ABSTRACT

Tremendous progress has been made over the past few years in diagnosing and treating infants and children with human immunodeficiency virus (HIV) infection. However, much remains to be done to effectively scale up and sustain prevention efforts and treatment services for all in need. The most efficient and cost-effective way to tackle paediatric HIV globally is to reduce mother-to-child transmission (MTCT). In 2008, an estimated 45% of pregnant women living with HIV received antiretrovirals (ARVs) to prevent transmission of HIV to their children. From the results obtained , the prevalence in the year 2017 recorded the highest number of patients, male 52.3%,  female 47.5%, CD4 counts > 500 cells /mm³ and <350 cells/mm³  undergoing ART therapy within the duration of the study.  However, every day, there are nearly 1 200 new infections in children less than 15 years of age, more than 90% of them occurring in the developing world and most being the result of transmission from mother to child. HIV-infected infants frequently present with clinical symptoms in the first year of life. Without effective treatment, an estimated one third of infected infants will have died by one year of age, and about half will have died by two years of age. While progress has been made in preventing new HIV infections in infants and children, greater efforts are needed to scale up these effective preventive interventions as well as services for care and treatment.

CHAPTER ONE

1.0 INTRODUCTION AND LITERATURE REVIEW

1.1 INTRODUCTION

The most efficient and cost-effective way to tackle pediatric HIV globally is to reduce mother-to-child transmission (MTCT). However, every day there are nearly 1500 new infections in children under 15 years of age, more than 90% of them occurring in the developing world and most being associated with MTCT (1). HIV-infected infants frequently present with clinical symptoms in the first year of life, and by one year of age an estimated one-third of infected infants will have died, and about half by 2 years of age. There is thus a critical need to provide antiretroviral therapy (ART) for infants and children who become infected despite the efforts being made to prevent such infections. In countries where it has been successfully introduced, ART has substantially changed the face of HIV infection. HIV-infected infants and children now survive to adolescence and adulthood. In resource-limited settings, like in African setups countries are hit by the epidemic, unprecedented efforts are made to rapidly scale up access to ART and have led to remarkable progress. However, this urgency and intensity of effort have met with less success in extending the provision of ART to HIV-infected children. Significant obstacles to scaling up paediatric care remain. inconclusive limited screening for HIV, a lack of affordable simple diagnostic testing technologies, a lack of human capacity, insufficient advocacy and understanding that ART is efficacious in children, as limited experience with simplified standardized treatment guidelines, and lack of affordable practicable pediatric antiretroviral (ARV) formulations. Consequently, few children have been on ART in resource-limited settings. Moreover, the need to treat an increasing number of HIV-infected children highlights the primary importance of preventing the transmission of the virus from mother to child in the first place.

WHO guidelines for the use of ART in children were considered within the guidelines for adults published in 2004. Revised, stand-alone comprehensive guidelines based on a public health approach have been developed in order to support and facilitate the management and scale-up of ART in infants and children.

The present guidelines are part of WHO’s commitment to achieve universal access to ART by 2010. Related publications include the revised treatment guidelines for adults (W.H.O 2006), revised guidelines on ARV drugs for treating pregnant women and preventing HIV infection in infants, guidelines on the use of co-trimoxazole preventive therapy (CPT), and revised WHO clinical staging for adults and children.

1.2 Justification of Study

ART treatment has been so successful that in many parts of the world. HIV has become a chronic condition in which progression to AIDS is increasingly rare. According to Anthony Fauci, head of the United States National Institute of Allergy and Infectious Diseases, “With collective and resolute action now and a steadfast commitment for years to come, an AIDS-free generation is indeed within reach.” In the same paper, he noted that an estimated 700,000 lives were saved in 2010 alone by antiretroviral therapy. As another commentary in The Lancet noted, “Rather than dealing with acute and potentially life-threatening complications, clinicians are now confronted with managing a chronic disease that in the absence of a cure will persist for many decades.” The World Health Organization has defined health as more than the absence of disease. For this reason, many researchers have dedicated their work to better understanding the effects of HIV-related stigma, the barriers it creates for treatment interventions, and the ways in which those barriers can be circumvented.

1.3 Aim and Objectives of study

1.3.1 Aim

The aim of this study is to assess the rate of infants using 5 years data undergoing Antiretroviral Therapy in Anambra hospital, Aroma.

1.3.2 Objectives of study

1. Prevalence of HIV infections in infants and children.
2. Age/sex related prevalence
3. To determine the timing to embark on ART treatments in under 18 months of age patients
4. To access the clinical and laboratory monitoring of ART therapy.
5. CD4 counts in infants before and after ART therapy.
   

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   Pages:  47

   Category: Project

   Format:  Word & PDF         

   Chapters: 1-5                                 

   Material contains Table of Content, Abstract and References.

   

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