Clinical, Virologic, Immunologic Outcomes and Emerging HIV Drug Resistance Patterns in Children and Adolescents in Public ART Care in Zimbabwe

OBJECTIVE: To determine immunologic virologic outcomes and drug resistance among children and adolescents receiving care during routine programmatic implementation in a low-income country. METHODS: A cross-sectional evaluation with collection of clinical and laboratory data for children (0- /= 5 years) at ART initiation was associated with severe stunting (HAZ /=4 years had higher failure rates than those on ART for <4 years (39.6% vs. 23.9% p = 0.0239). In those initiating ART as adolescents each additional year in age above 10 years at the time of ART initiation (AOR 0.4 95%CI: 0.1 0.9 p = 0.0324) and each additional year on ART (AOR 0.4 95%CI 0.2 0.9 p = 0.0379) were associated with decreased risk of virologic failure. Drug resistance was evident in 67.6% of sequenced virus isolates. CONCLUSIONS: During routine programmatic implementation of HIV care for children and adolescents delayed age at ART initiation has long-term implications on immunologic recovery growth and virologic outcomes.