Paediatric human immunodeficiency virus treatment outcomes from a resource-limited setting in South Africa: Highly active antiretroviral therapy alone is not enough

Abstract Comprehensive care of human immunodeficiency virus (HIV)-infected children in the resource-poor setting is challenging, and published reports on treatment outcomes in this setting are limited. The aim of this study was to evaluate outcomes of HIV-infected children initiated on highly active antiretroviral therapy (HAART) between April 2005 and April 2009 at a primary health-care centre in Alexandra Township, South Africa. Of the 337 patients initiated on HAART, 83% (281 of 337) were still in care at the time of analysis. The median age at initiation was five years six months [interquartile range (IQR) 2.4–8.8], with only 11% (37 of 337) less than 1 year of age. At one and two years of treatment follow-up, the mean increase in CD4% was 12.8% (8.7–17.4) and 17.9% (11.7–21.6), respectively, while 86% (172 of 199) and 88% (99 of 112) were virally suppressed. Improvement in body mass index (BMI), height-for-age (HAZ) and weight-for-age Z scores (WAZ), along with low rates of lost to follow-up (3.6%; 1...