BACKGROUND Abacavir (ABC) and Zidovudine (AZT) based regimens are the preferred first line nucleoside reverse transcriptase (NRTIs) backbones being widely utilized for managing HIV infection in children. However, there is a dearth of data regarding the clinical outcomes and associated risk factors in Ethiopia. We compared the proportion of mortality and the rate of occurrence of Opportunistic Infections (OIs) with ABC versus AZT -based regimens in a cohort of HIV-infected children. METHODS A 42 months retrospective cohort study was conducted. A total of 179 records were reviewed by including data from October 2014 to April 2017. Data were collected on socio-demographic, clinical characteristics of patients and drug related variables. Data were analyzed using STATA13.1. Kaplan-Meier and Cox regression were used to compare survival experience and identify independent predictors. Propensity score matching analysis was conducted to elucidate the average treatment effects of each regimen over OIs. RESULT Of 179 patients, 98 (54.7%) were females. The mean (+SD) age of the study subjects was 6.53 ± 2.83 years. Through 42 months analysis, a total of 4 patients (1 (1.14%) from ABC group and 3 (3.3%) from AZT group (p = 0.339)) were died. The incidence of opportunistic infections attributed to ABC group was 8.77/100,000 person years (py) and that of AZT was 6.9/100,000py. The incidence rate ratio (IRR) for OIs was (IRR = 0.87, 95% CI [0.49-1.53] (p = 0.304). Baseline CD4 count (AHR = 0.99, 95% CI [0.98-0.99]), Severe acute malnutrition (AHR = 15.92, 95% CI [5.34-47.50]), and exposure to tuberculosis treatment (AHR = 2.93, 95% CI [1.39-6.17]) were the independent predictors for the development of OIs. CONCLUSION ABC and AZT based ART regimens seem to have comparable survival benefit among HIV-infected children in Ethiopia. Therefore, both regimens might be used as an alternative in resource limited settings.

中文翻译：

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阿巴卡韦与齐多夫定为基础的方案在资源有限的情况下治疗HIV感染儿童：一项回顾性队列研究。

背景技术基于阿巴卡韦（ABC）和齐多夫定（AZT）的方案是优选的一线核苷逆转录酶（NRTIs）骨架，被广泛用于控制儿童的HIV感染。但是，关于埃塞俄比亚的临床结局和相关危险因素的数据匮乏。我们比较了艾滋病毒感染儿童队列中以ABC和AZT为基础的方案的死亡率和机会性感染（OIs）发生率。方法进行了42个月的回顾性队列研究。纳入2014年10月至2017年4月的数据，共审查了179条记录。收集了有关社会人口统计学，患者临床特征和药物相关变量的数据。使用STATA13.1分析数据。使用Kaplan-Meier和Cox回归比较生存经验并确定独立的预测因素。进行倾向得分匹配分析以阐明每种方案对OI的平均治疗效果。结果179例患者中，有98例（54.7％）为女性。研究对象的平均（+ SD）年龄为6.53±2.83岁。经过42个月的分析，总共有4例患者（ABC组1例（1.14％）和AZT组3例（3.3％）（p = 0.339））死亡。归因于ABC组的机会性感染发生率是8.77 / 100,000人年（py），而AZT发生率是6.9 / 100,000100,000py。OI的发生率比（IRR = 0.87，95％CI [0.49-1.53​​]（p = 0.304）。基线CD4计数（AHR = 0.99，95％CI [0.98-0.99]），严重急性营养不良（AHR = 15.92，95％CI [5.34-47.50]），并接受结核病治疗（AHR = 2。93％的CI [1.39-6.17]是OI发展的独立预测因子。结论基于ABC和AZT的ART方案在埃塞俄比亚的HIV感染儿童中似乎具有可比的生存获益。因此，这两种方案都可以在资源有限的环境中用作替代方案。