Therapeutic and Evolutionary Aspects of Antiretroviral Treatment (ART) for Children in Libreville

Background: HIV remains a major public health problem worldwide. Without treatment, the disease progresses rapidly in children, half of whom die before the age of 2. The aim was to study the therapeutic and evolutionary aspects of HIV infection in children followed up in the various care centres. Materials and methods: This was a retrospective study involving children followed up in paediatric CTAs in Libreville from January 2015 to December 2022. We included children aged 0-19 years with positive HIV serology or PCR. Statistical analysis was performed using SPSS version 25 software. The significance level was set at 5%. Results: 288/345 cases were accepted, representing a participation rate of 83.5%. The mean age was 10.6 ± 5.1 years. The 10-14 age groups accounted for 32.3%. We had 84.6% of patients with moderate or severe immunity at entry. At ART initiation, 81.9% of our patients were on treatment and 19.1% were not. The 2INTI+INNTI (38.9%) and 2INTI + II (49%) combinations were the most commonly used. The drugs administered were Lamivudine (34%), Dolutegravir (23.6%), Tenofovir (26.4%) and Abacavir (17.7%). The course of treatment showed 92.4% follow-up, 2.8% deaths and 4.9% lost to follow-up. Conclusion: HIV-AIDS in children remains a public health problem, given its socio-economic impact on the population. The high cost of follow-up tests and supply shortages are among the problems that slow down regular patient follow-up.