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Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe

Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10–30 years who were initiated...

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Autores principales: Bygrave, Helen, Mtangirwa, Judith, Ncube, Kwenzakwenkosi, Ford, Nathan, Kranzer, Katharina, Munyaradzi, Dhodho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527625/
https://www.ncbi.nlm.nih.gov/pubmed/23285204
http://dx.doi.org/10.1371/journal.pone.0052856
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author Bygrave, Helen
Mtangirwa, Judith
Ncube, Kwenzakwenkosi
Ford, Nathan
Kranzer, Katharina
Munyaradzi, Dhodho
author_facet Bygrave, Helen
Mtangirwa, Judith
Ncube, Kwenzakwenkosi
Ford, Nathan
Kranzer, Katharina
Munyaradzi, Dhodho
author_sort Bygrave, Helen
collection PubMed
description Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10–30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10–15 (young adolescents) 15.1–19 years (adolescents), 19.1–24 years (young adults) and 24.1–29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95%CI 1.17–4.35). Young adults and adolescents had a 2–3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95%CI 1.62–4.52). This study highlights the need for adapted adherence support and service delivery models for both adolescents and young adults.
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spelling pubmed-35276252013-01-02 Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe Bygrave, Helen Mtangirwa, Judith Ncube, Kwenzakwenkosi Ford, Nathan Kranzer, Katharina Munyaradzi, Dhodho PLoS One Research Article Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10–30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10–15 (young adolescents) 15.1–19 years (adolescents), 19.1–24 years (young adults) and 24.1–29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95%CI 1.17–4.35). Young adults and adolescents had a 2–3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95%CI 1.62–4.52). This study highlights the need for adapted adherence support and service delivery models for both adolescents and young adults. Public Library of Science 2012-12-20 /pmc/articles/PMC3527625/ /pubmed/23285204 http://dx.doi.org/10.1371/journal.pone.0052856 Text en © 2012 Bygrave et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Bygrave, Helen
Mtangirwa, Judith
Ncube, Kwenzakwenkosi
Ford, Nathan
Kranzer, Katharina
Munyaradzi, Dhodho
Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe
title Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe
title_full Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe
title_fullStr Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe
title_full_unstemmed Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe
title_short Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe
title_sort antiretroviral therapy outcomes among adolescents and youth in rural zimbabwe
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527625/
https://www.ncbi.nlm.nih.gov/pubmed/23285204
http://dx.doi.org/10.1371/journal.pone.0052856
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