Temporal changes in the outcomes of HIV-exposed infants in Kinshasa, Democratic Republic of Congo during a period of rapidly evolving guidelines for care (2007-2013).

摘要: OBJECTIVE: Guidelines for prevention of mother-to-child transmission HIV have developed rapidly yet little is known about how outcomes HIV-exposed infants changed over time. We describe infant in Kinshasa Democratic Republic Congo between 2007 and 2013. DESIGN: Cohort study mother-infant pairs enrolled family-centered comprehensive care. METHODS: Accounting competing risks we estimated the cumulative incidences early diagnosis death loss to follow-up combination antiretroviral therapy (cART) initiation three periods (2007-2008 2009-2010 2011-2012). RESULTS: 1707 at a median age 2.6 weeks. Among whose mothers had recently into care (N = 1411) access EID by two months increased from 28% (95% confidence limits [CL]: 2434%) among 2007-2008 63% CL: 5968%) 2011-2012 (Grays p-value <0.01). The 18-month incidence declined 16% 1122%) 11% 816%) 0.19). also 8% 512%) 3% 25%) 0.02). LTFU did not improve with 19% 1523%) 22% 1826%) 0.06). HIV-infected 24-month cART 61% 4375%) 97% 82100%) <0.01); decreased 17.9 9.3 months. Outcomes were better before pregnancy. CONCLUSIONS: observed encouraging improvements but continued efforts are needed.