antiretroviral therapy (ART)

The aim of the study was to investigate the prevalence of renal function and liver enzyme abnormalities among HIV‐infected children, changes in prevalence with time on combination antiretroviral therapy (cART), and the factors associated with these abnormalities. A high prevalence of liver enzyme and renal function abnormalities was observed at enrolment. Decreasing liver enzyme levels during follow‐up are possibly reassuring, while the progressive reduction in GFR and the increase in BUN are worrisome and require further study.

Persistent dyslipidemia in children is associated with risks of cardiovascular accidents and poor combination antiretroviral therapy (cART) outcome. We report on the first evaluation of prevalence and associations with dyslipidemia due to HIV and cART among HIV-infected Ethiopian children. High prevalence of cART-associated dyslipidemia, particularly low HDLc and hypertriglyceridemia, was observed among treatment-experienced HIV-infected children. The findings underscore the need for regular follow-up of children on cART for lipid abnormalities.

The success of the Namibian government’s “treatment for all” approach to control and stop the country’s HIV epidemic is dependent on an uninterrupted supply of antiretrovirals (ARVs) for people living with HIV. The public health system in Namibia, however, was constrained by an inefficient paper-based pharmaceutical information system resulting in unreliable and inaccessible data, contributing to persistent stock-outs of ARVs and other essential pharmaceuticals. This article describes the incremental implementation of an integrated pharmaceutical management information system to provide timely and reliable commodity and patient data for decision making in Namibia’s national antiretroviral therapy (ART) program and the Ministry of Health and Social Services (MoHSS). Namibia’s pharmaceutical management information system demonstrates the feasibility and benefits of integrating related tools while maintaining their specialized functionality to address country-specific information and inventory management needs.

In 2011, the Malawi Ministry of Health introduced option B+, a universal treatment strategy for the prevention of mother-to-child transmission (MTCT) of HIV. Under option B+, all pregnant or breastfeeding women with HIV are eligible for lifelong antiretroviral therapy (ART) regardless of clinical stage or CD4. Routine data from Malawi's prevention of MTCT option B+ programme suggest high uptake of antiretroviral therapy (ART) among pregnant women. Malawi's Ministry of Health led the National Evaluation of Malawi's PMTCT Program to obtain nationally representative data on maternal ART coverage and prevention of MTCT effectiveness. Here we present the early transmission data for infants aged 4–12 weeks and used a multistage cluster design to recruit a nationally representative sample of HIV-exposed infants and their mothers. Between October 16, 2014 and May 17, 2016, we screened for HIV in all mothers attending an under-5 vaccination or outpatient sick-child clinic with infants aged 4–26 weeks. They confirmed HIV exposure in 3542 (10·4%) of 33 980 mother (guardian)–infant pairs with infants aged 4–26 weeks. These data suggest that Malawi's decentralization of ART services has resulted in higher ART coverage and lower early MTCT. However, the uptake of services for HIV-exposed infants remains suboptimal.

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