Viral load versus CD4⁺ monitoring and 5-year outcomes of antiretroviral therapy in HIV-positive children in Southern Africa: a cohort-based modelling study.

ABSTRACT:

Objectives

Many paediatric antiretroviral therapy (ART) programmes in Southern Africa rely on CD4⁺ to monitor ART. We assessed the benefit of replacing CD4⁺ by viral load monitoring.

Design

A mathematical modelling study.

Methods

A simulation model of HIV progression over 5 years in children on ART, parameterized by data from seven South African cohorts. We simulated treatment programmes with 6-monthly CD4⁺ or 6- or 12-monthly viral load monitoring. We compared mortality, second-line ART use, immunological failure and time spent on failing ART. In further analyses, we varied the rate of virological failure, and assumed that the rate is higher with CD4⁺ than with viral load monitoring.

Results

About 7% of children were predicted to die within 5 years, independen

SUBMITTER: Salazar-Vizcaya L 

PROVIDER: S-EPMC4231439 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature