@article{fdi:010065296,
  title = {{C}ould caregiver reporting adherence help detect virological failure in {C}ameroonian early treated {HIV}-infected infants ?},
  author = {{N}dongo, {F}. {A}. and {W}arszawski, {J}. and {T}exier, {G}. and {P}enda, {I}. and {N}diang, {S}. {T}. and {N}dongo, {J}. {A}. and {G}uemkam, {G}. and {S}ofeu, {C}. {L}. and {K}futwah, {A}. and {F}aye, {A}. and {M}sellati, {P}hilippe and {T}ejiokem, {M}. {C}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {V}iral load is still the marker of choice for monitoring adherence to combined antiretroviral therapy (c{ART}) and confirming the success of {HIV} treatment. {U}nfortunately it is difficult to access in many resource-poor settings. {W}e aimed to measure the performance of caregiver reporting adherence for detecting virological failure in routine practice during the first 2 years after c{ART} initiation in infants. {M}ethods: {PEDIACAM} is an ongoing prospective cohort study including {HIV}1-infected infants diagnosed before 7 months of age between {N}ovember 2007 and {O}ctober 2011 in {C}ameroon. {A}dherence was assessed using a questionnaire administered every 3 months from c{ART} initiation; the {HIV}-{RNA} viral load was determined at the same visits. {V}irological failure was defined as having a viral load >= 1000 cp/m{L} at 3 and 12 months after c{ART} initiation or having a viral load >= 400 cp/m{L} at 24 months after c{ART} initiation. {T}he performance of each current missed and cumulative missed dose defined according to adherence as reported by caregiver was assessed using the viral load as the gold standard. {R}esults: c{ART} was initiated at a median age of 4 months ({IQR}: 3-6) in the 167 infants included. {T}he cumulative missed dose showed the best overall performance for detecting virological failure after 12 months of c{ART} ({AUC} test, p = 0.005, {LR} + = 4.4 and {LR}-=0.4). {W}hatever the adherence reporting criterion, the negative predictive value was high ({NPV} >= 75 %) 12 and 24 months after c{ART} initiation, whereas the positive predictive value was low ({PPV} <= 50 %). {C}onclusions: {T}he adherence questionnaire administered by the health care provider to the infants' caregivers is not reliable for detecting virological failure in routine practice: its positive predictive value is low. {H}owever, the cumulative missed dose measurement may be a reliable predictor of virological success, particularly after 12 months of c{ART}, given its high negative predictive value.},
  keywords = {{A}ntiretroviral therapy ; {I}nfants ; {A}dherence reporting ; {V}irological ; failure ; {R}esource-limited settings ; {CAMEROUN}},
  booktitle = {},
  journal = {{B}mc {P}ediatrics},
  volume = {15},
  numero = {},
  pages = {art. 132 [9 p.]},
  ISSN = {1471-2431},
  year = {2015},
  DOI = {10.1186/s12887-015-0451-3},
  URL = {https://www.documentation.ird.fr/hor/fdi:010065296},
}