The Effectiveness of 2 Years of First Line Antiretroviral Therapy among HIV-Infected Children at an Integrated HIV-Care Clinic in Myanmar

Objective: To study the effectiveness of 2 years first line antiretroviral therapy on weight for age, haemoglobin, CD4 count among HIV infected children at integrated HIV-care clinic, Mandalay Children hospital (MCH). Method: This study was prospective cohort study performed on a total of 116 HIV infected children who started Anti Retroviral Therapy (ART) from 1st January to 31st December of 2010. At the start of the study, ART treatment has been established for one to two years. The follow up period was up to one year. Weights, weight for age, haemoglobin and CD4 counts were obtained from the medical records of individual patient at the start of ART and also at one year of ART for some children. Data were also recorded at 2 years of ART therapy. During every visit, each case of death, defaulter and regular follow-up and loss to followup cases were recorded. The reviews of medical records of patients at follow-up visits were done. Then, two years survival was calculated. Results: Out of 116 cases, 85 (73.28%) patients were < 3rd centile weight for age at ART initiation. After 1 year of ART, 74 (73.27%) cases were > 3rd centile and 88 (92.63%) cases were > 3rd centile after 2 years of ART. The median increase in weight at 1 year of ART was 3 kg (p=<0.001), and at 2 years was 7 kg (p =<0.001). At the start of ART 31.90% children had < 9 g/dl hemoglobin, but 1.98% and 4.21% of cases were Conclusion: Good survival, positive effect on growth, hemoglobin status and CD4 count can be sustained after two years of first line ART among HIV infected children in resource-constrained settings. Low CD4 count and low haemoglobin status at the start of ART could have considerable impact on growth and other associated infections such as tuberculosis, viral hepatitis, and chronic diarrhea.