Increases in Pediatric Antiretroviral Treatment, South Africa 2005–2010

Background: In South Africa in 2010 about 340000 children under the age of 15 were infected with HIV. We describe the increase in the treatment of South African pediatric HIV-infected patients assisted by the Presidents Emergency Plan for AIDS Relief (PEPFAR) from 2004 to 2010. Methods: We reviewed routine program data from PEPFAR-funded implementing partners among persons receiving antiretroviral treatment age 15 years old and less. Data quality was assessed during the reporting period by program officials through routine analysis of trends and logic checks. Based on UNAIDS estimated mortality rates of untreated HIV-infected children we calculated the number of deaths averted and life-years gained in children under five receiving PEPFAR-assisted antiretroviral treatment. Results: From October 2004 through September 2010 the number of children newly initiated on antiretroviral treatment in PEPFAR-assisted programs increased from 154 to 2641 per month resulting in an increase from 2412 children on antiretroviral treatment in September 2005 to 79416 children in September 2010. Of those children who initiated antiretroviral treatment before September 2009 0-4 year olds were 1.4 (95% CI: 1.3-1.5) times as likely to transfer out of the program or die as 5-14 year olds; males were 1.3 (95% CI: 1.0-1.7) times as likely to stop treatment as females. Approximately 27548 years of life were added to children under-five years old from PEPFAR-assisted antiretroviral treatment. Conclusions: Pediatric antiretroviral treatment in South Africa has increased substantially. However additional case-finding and a further acceleration in the implementation of pediatric care and treatment services is required to meet the current treatment need.