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The article presents a study which states that CD4 + cell count testing is more effective than HIV disease clinical staging in identifying pregnant and postpartum women eligible for antiretroviral therapy (ART) in resource-limited settings. It mentions that the researchers compared immunologic and clinical criteria data based on the 2009 World Health Organization (WHO) ART guidelines. The authors conclude that CD4 + cell count is more effective than clinical staging.

Medication adherence is critical for children''s HIV treatment success, but obtaining accurate assessments is challenging when complex measurement technologies are not feasible. Our goal was to evaluate a multidimensional adherence interview designed to improve on existing adherence measures. Data from caregivers (N = 126) of perinatally infected children were analyzed to determine the ability of the revised interview guide to detect potential treatment nonadherence. Questions related to viral load (VL) on a bivariate level included proportion of doses taken in the previous 3 days and 6 months, caregivers'' knowledge of prescribed dosing frequencies, and caregivers'' reports of problems associated with medication administration. VL was not associated with 3-day recall of missed doses. In multivariate analyses, only caregiver knowledge of prescribed dosing frequencies was uniquely associated with VL. Our modified interview appears to successfully identify family struggles with adherence and to have the capacity to help clinicians address medication adherence challenges. [Copyright &y& Elsevier]

The article focuses on the implementation of routine HIV antibody testing and counseling program for pediatric patients at University Teaching Hospital (UTH) in Lusaka, Zambia. It states that the Pediatric Center of Excellence (PCOE) was set up in UTH to offer complete care and training to HIV-infected and HIV-exposed children and disseminate pediatric HIV expertise. It notes that the program was able to determine large numbers of HIV-seropositive children placed in high prevalence settings.

The article examines the effects of protease inhibitors (PIs) on lipid measures in a large cohort of perinatally human immunodeficiency virus (HIV)-infected children followed from birth in the U.S. A longitudinal analysis was conducted to HIV-infected children participating in Perinatal AIDS Collaborative Transmissions Study (PACTS). The study concluded that children on PI-containing regimens have a higher risk of both hypercholesteremia and hypertriglyceridemia.

Objective(s): Few data are available from resource-limited countries on long-term outcomes of HIV-infected women who initiate antiretroviral therapy (ART) during pregnancy., Design: Analysis of data from adult patients enrolled in the MTCT-Plus Initiative who initiated ART between 2003 and 2006 in seven countries in Sub-Saharan Africa and Thailand., Methods: Mean population changes were assessed and multivariable mixed linear regression modeling was used to examine covariate effects on differences in absolute CD4 cell count responses. Kaplan-Meier methods were used to examine program retention combining survival and losses to follow-up., Results: Of 2229 individuals initiating ART, 1688 were women, of which 605 were pregnant (median gestational age 7 months), 1083 were not pregnant, and 541 were men. The average CD4 response by 30 months on ART was 451 cells/microl among women who were pregnant at ART initiation as compared with 435 cells/microl among nonpregnant women (P = 0.53) and 349 cells/microl among men (P < 0.001). In multivariable analysis, lower CD4 cell increase was independently associated with male sex, older age, and lower CD4 cell count at initiation. After 30 months on ART retention was 0.85 with no retention differences between pregnant women, nonpregnant women, and men., Conclusion: HIV-infected women in resource-limited countries who start ART during pregnancy have similar or better long-term CD4 cell count responses as compared with other adults. These data support efforts to provide pregnant HIV-infected women with access to ART in resource-limited countries.

Objective: HIV-infected women need access to safe and effective contraception. Recent animal and human data suggest that hormonal contraception may accelerate HIV disease progression., Methods: We compared the incidence of HIV disease progression among antiretroviral therapy-naive women with and without exposure to hormonal contraception at 13 sites in Africa and Asia. Disease progression was defined as becoming eligible for antiretroviral therapy or death., Results: Between 1 August 2002 and 31 December 2007, the MTCT-Plus programs enrolled 7846 women. In total, 4109 (52%) women met eligibility criteria for this analysis and contributed 5911 person-years of follow-up (median follow-up, 379 days; interquartile range, 121-833). At baseline, 3064 (75%) women reported using either no contraception or a nonhormonal method, whereas 823 (20%) reported using implants/injectables and 222 (5%) reported using oral contraceptive pills. The disease progression outcome was met by 944 (29%) women (rate, 18.3/100 woman-years). Neither implants/injectables (adjusted hazard ratio 1.0, 95% confidence interval 0.8-1.1) nor oral contraceptive pills (adjusted hazard ratio 0.8, 95% confidence interval 0.6-1.1) were associated with disease progression. Treating contraceptive method as a time-varying exposure did not change this negative finding., Conclusion: This multicountry cohort analysis provides some reassurance that hormonal contraception is not associated with HIV disease progression. Further research is needed to address the contraceptive needs of HIV-infected women.