Outcomes of children with advanced HIV initiated on antiretroviral therapy in a South African hospice.

Background: Little is known about the long-term outcome of antiretroviral therapy (ART) for children with advanced-stage HIV. Aim: To assess the outcome in children with advanced HIV initiated on ART. The predictors for survival, general wellbeing and the role of palliative care were assessed. Methods: Patient files, retained patient records and personal follow-up were used for data collection. Data on baseline characteristics, ART treatment and progress were collected at baseline, 6, 12 and 48 months. Information regarding general wellbeing and school attendance and performance were collected. Results: 37 children were started on ART. At 48 months there were 18 known survivors and 7 known to have died. Another 12 were transferred to another programme or lost to follow-up. There was no significant difference in baseline characteristics between groups. All eligible children attended school and all received medical care. The hospice programme offered holistic care and support. Conclusions: No baseline characteristic could predict the outcome of children with advanced HIV initiated on ART. A hospice support programme can contribute to positive outcomes even when ART is initiated in children with advanced disease. [ABSTRACT FROM AUTHOR]