Quality of antiretroviral treatments in the pediatric population living with HIV in the province of Buenos Aires

Abstract

Introduction: Human immunodeficiency virus (HIV) infection is a major global health problem. The introduction of antiretroviral treatment (ART) has represented a before and after in the natural history of the infection, improving quality of life. In pediatrics, however, therapeutic options are scarce and recommendations are updated quickly, requiring health professionals to carry out continuous reviews of the scientific evidence. Objective: Describe the factors that influence the quality of antiretroviral treatments in the pediatric population living with HIV in the province of Buenos Aires, from the perspective of health professionals. Patients and Methods: Observational, descriptive, cross-sectional study. The characterization of pediatric ART until March 2023 was carried out using the databases offered by the Argentine Integrated Health Information System. To assess the perception of the members of the health team, virtual questionnaires were carried out with professionals who assist people living with HIV under the age of 15, inclusive, in public hospitals in the province of Buenos Aires, after signing informed consent. Results: 365 children and adolescents under 15 years of age living with HIV were registered. When evaluating dosage data and ART selection scheme according to age, 15.8% of the patients (n=58) received an Appropriate Treatment, while the rest (n=307) received an Alternative Treatment, that is, second-class treatment. line. Virtual questionnaires were administered to 87.8% of professionals, representing all regions. 90.7% highlighted the importance of specialization in the quality of treatments. Among the accessibility barriers, the scarcity of therapeutic alternatives and, in relation to adherence, the lack of accompanying caregivers in treatments was mentioned as most relevant. Conclusions: Existing ART guidelines should be applied more consistently, since a low percentage of pediatric patients received adequate treatments. Given the evident lack of pediatric formulations, the public production of pediatric antiretroviral syrup medication must be promoted. It is necessary to expand the coverage in the province of Buenos Aires of people trained in pediatric HIV and plan joint work with caregivers, family members and people who They work with children living with HIV.