Antiretroviral treatment in Rwandan children living with HIV PDF
Preview Antiretroviral treatment in Rwandan children living with HIV
UvA-DARE (Digital Academic Repository) Antiretroviral treatment in Rwandan children living with HIV: Clinical and psychosocial outcomes Mutwa, R. Link to publication Citation for published version (APA): Mutwa, R. (2015). Antiretroviral treatment in Rwandan children living with HIV: Clinical and psychosocial outcomes. General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. 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UvA-DARE is a service provided by the library of the University of Amsterdam (http://dare.uva.nl) Download date: 14 Jun 2020 Bookmark design and/or information to be supplied by client AAnntitrieretrtroovviriraall TTrreeaattmment i n Rwaannddaann C Chhilidldrerenn 60 x 240 mm (ex. bleed) LLiviviningg w witithh HHIIVV:: CClinical anndd PPssyycchhoossoocciaial l Outcomes Rwatana MUTWA Rwatana MUTWA 209575-os-Mutwa.indd 1 09-09-15 12:07 P20ro9c5e7s5s-eLd-o osn-M: 9u_tw9a_2015 Antiretroviral Treatment in Rwandan Children Living with HIV: Clinical and Psychosocial Outcomes Rwatana MUTWA Antiretroviral Treatment in Rwandan Children Living with HIV: Clinica land Psychosocia l Outcomes Rwatana Mutwa 209575-L-bw-Mutwa Colofon Copyright © 2015, Philippe, Rwatana Mutwa, Kigali, Rwanda. “Antiretroviral Treatment in Rwandan Children Living with HIV: Clinical and Psychosocial Outcomes”. Thesis University of Amsterdam (UvA) http://dare.uva.nl/dissertaties The studies included in this thesis were supported by INTERACT Project. The printing of this thesis was financially supported by Academic Medical Center (AMC, Amsterdam, and the AIGHD, Amsterdam, The Netherlands. Cover design: Henita Kuntawala Lay out: AIGHD, Amsterdam, The Netherlands. Printing: Ipskamp Drukkers, Enschede Reprints were made with permission from the publishers, where appropriate. No part of the thesis may be reproduced, stored, or transmitted without the prior written permission of the author or, when appropriate, the publishers of the articles. 209575-L-bw-Mutwa Antiretroviral Treatment in Rwandan Children Living with HIV: Clinical and Psychosocial Outcomes ACADEMISCH PROEFSCHRIFT ter verkrijging van de graad van doctor aan de Universiteit van Amsterdam op gezag van de Rector Magnificus prof. dr. D. C. van den Boom ten overstaan van een door het College voor Promoties ingestelde commissie, in het openbaar te verdedigen in de Agnietenkapel op donderdag 29 oktober 2015, te 12:00 uur door Rwatana Mutwa geboren te Uvira, Democratsche Republiek Congo 209575-L-bw-Mutwa Promotiecommissie : Promotor: Prof. dr. P. Reiss Universiteit van Amsterdam Copromotores: Dr. S.P.M. Geelen Wilhelmina Kinderziekenhuis Dr. K.R. Boer Koninklijk Instituut voor de Tropen Overige leden: Prof. dr. F.G.J. Cobelens Universiteit van Amsterdam Prof. dr. M. Boele van Hensbroek Universiteit van Amsterdam Prof. dr. A.P. Hardon Universiteit van Amsterdam Prof. dr. M.D. de Jong Universiteit van Amsterdam Prof. dr. D.M. Burger Radboud Universiteit Nijmegen Dr. T.F.W. Wolfs UMC Utrecht Faculteit der Geneeskunde 209575-L-bw-Mutwa Contents CONTENT S ACRONYM USSED IN THIS THESI S......................................................................................... 7.. ...... Chapter1 .Pediatric and adolescen tHIV care and services in Rwanda :achievement sand challenge sover 10 years .................................................................................................... 1..0.. ..... Chapter 2. Safety and effectiveness of combination antiretroviral therapy during the first year of treatment in HIV‐1 infected Rwandan children: a prospective study. ................................ .3..8 Chapter 3. Long‐term Effectivenes sof Combination Antiretroviral Therapy and Prevalence of HIV Drug Resistanc ein HIV‐1–infected Children and Adolescent sin Rwanda ......................... .7.0 Chapter 4. Mid‐Dosing Interval Efavirenz Plasma Concentration sin HIV‐1–Infected Children in Rwanda :Treatment Efficacy ,Tolerability ,Adherence ,and the Influence of CYP2B 6 Polymorphism .s................................................................................................................ .9..6. ....... Chapter 5. Hepatitis B virus prevalence and vaccine response in HIV‐infected children and adolescent son combination antiretroviral therapy in Kigali ,Rwanda ................................. .1..11 Chapter 6. Living situations affect cART adherence in HIV‐infected adolescent sin Rwanda ;a qualitative study ............................................................................................................. .1..3..5. ..... Chapter 7. “Let's Talk about Sex”: A Qualitative Study of Rwandan Adolescents V' iews on Sex and HIV .......................................................................................................................... .1..6..1 Chapter 8. GENERA DLISCUSSIO CNO, NCLUSIO NASND RECOMMENDATIO N...S.................. .1.81 SUMMARY/SAMENVATT I.N...G........................................................................................ .1..9..6. ... AUTHOR SAND AFFILIATION ..S......................................................................................... .2..0..4. ... ACKNOWLEDGMEN ..T..S................................................................................................. .2..0..6. .... PhD PORTFOL I.O............................................................................................................ .2..0..9. ..... ABOUT THE AUTHOR ....................................................................................................... .2..1..1. .... HAART in Rwandan IHV‐Infected Children 5 | P a g e 209575-L-bw-Mutwa HAART in Rwandan IHV‐Infected Children 6 | P a g e 209575-L-bw-Mutwa Abbreviations ACRONYM USSED IN THIS THESI S 3TC: lamivudine 95%CI: 95% confidence interval ABC: abacavi r AE: Adverse event AIDS: acquired immune deficiency syndrome ANC: Antenata lCare anti‐HBc: antibody to hepatitis B virus core antigen anti‐HBs: antibody to hepatitis B virus surface antigen ALT: Alanine Amino Transferas e AST: Aspartate Amino Transferas e ART: antiretroviral treatment AZT: zidovudine CA: California cART: combination antiretroviral therapy CYP2B6: cytochrome P450 (CYP 2) B6 CNS: Centra lNervous system D4T: stavudine DAIDS: Division of AIDS DDI: Didanosine DNA: deoxyribonuclei cacid DHS: Demographi cand Health Survey EDPRS: Economic Developmen tand Poverty Reduction Strategy EFV: efavirenz EMR: Electronic Medical Record eMTCT: elimination of Mother to Child Transmissio n FGD: focus group discussion GA: Georgia GEE: generalizing estimating equation HAART: Highly Active Antiretroviral Therapy HAZ: height‐for‐age HBsAg: hepatitis B virus surface antigen HBV: hepatitis B virus HIV‐1: human immunodeficiency virus type‐1 HSSPs: Health Sector Strategic Plans IDI: in‐depth interviews INTERACT: Infectious Disease sNetwork for Treatment and Researc hin Africa IQR: interquartile range IRIS: immune reconstitution inflammatory syndrome HAART in Rwandan IHV‐Infected Children 7 | P a g e 209575-L-bw-Mutwa Abbreviations LMIC: Low‐ and middle‐income countries LPV/r: lopinavir/ritonavir MeSH: Medical Subjec tHeadings MTCT: Mother to Child Transmissio n NNRTI: non‐nucleoside reverse transcriptase inhibitor NPV: nevirapine NRTI: nucleoside reverse transcriptase inhibitor NSP: National Strategy Plan NRL: National Reference Laboratory OR: odds ratio PCR: Polymerase chain reaction PI: protease inhibitor PMTCT: prevention of mother to child transmission PRSPs: Poverty Reduction Strategy Papers RNA: Ribonucleic acid RNEC: Rwanda National Ethics Committee SD: standard deviations TAM: thymidine analogue mutation TB: Tuberculosi s TDF: tenofovir TRACplus: Treatment and Researc hAIDS Center TX: Texas UNAIDS: Joint United Nations Programme on HIV/AIDS UNICEF: United Nations Children's Fund USA: United States of America US: United States USAID: United States Agency for International Developmen t VL: Viral load WAZ: weight‐for‐age WHO: World Health Organization HAART in Rwandan IHV‐Infected Children 8 | P a g e 209575-L-bw-Mutwa
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