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Antiretroviral Therapy for HIV Infection in Infants and Children: Towards Universal Access Recommendations for a Public Health Approach 2010 Revision. WHO (2010)Tremendous progress has been made over the past few years in diagnosing and treating infants and children with human immunodeficiency virus (HIV) infection. However, much remains to be done to effectively scale-up and sustain prevention efforts and treatment services for all in need. The most efficient and cost-effective way to tackle paediatric HIV globally is to reduce mother-to-child transmission (MTCT). In 2008, an estimated 45% of pregnant women living with HIV received antiretrovirals (ARVs) to prevent transmission of HIV to their children. However, every day, there are nearly 1 200 new infections in children less than 15 years of age, more than 90% of them occurring in the developing world and most being the result of transmission from mother to child.

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WHO Recommendations on the Management of Diarrhoea and Pneumonia in HIV-Infected Infants and Children: Integrated Management of Childhood Illness (IMCI). WHO (2010)The main causes of death among children under 5 years of age are acute respiratory infection (17%) and diarrhoeal disease (16%), and children infected with human immunodeficiency virus (HIV) have greater morbidity and mortality related to these conditions (WHO, 2008). An estimated 2.1 million children in the world are living with HIV, 90% of whom live in sub-Saharan Africa.

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Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infections in Infants Recommendations for a Public Health Approach 2010 Version. WHO (2010)Significant progress is being made in the global scale-up of prevention of mother-to-child transmission of HIV (PMTCT), including in high burden and resource-limited settings. For the first time, the elimination of mother to-child transmission of HIV (MTCT) is now considered a realistic public health goal and an important part of the campaign to achieve the millennium development goals. In the light of the global effort, it is critically important to provide the best evidence-based interventions to reduce the risk of transmission from an HIV-infected mother to her newborn child, while at the same time promoting the health of both the mother and the child.

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The combined efforts of countries and international partners have resulted in substantial advances in HIV treatment and prevention. Nonetheless, access to key HIV services remains low in many settings around the world, and there are still major research gaps about the best way to expand HIV testing, prevention and treatment, especially in resource-limited settings. The World Health Organization (WHO) has endorsed the “learning by doing” approach, which advocates that public health strategies to scale up HIV treatment and prevention services be continuously reviewed, evaluated and revised, so that the results of research can inform programmes as quickly as possible (WHO 2006).


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Rapid Advice: Antiretroviral Therapy for HIV Infection in Adults and Adolescents. WHO (2009)The guideline Antiretroviral therapy for hiv infection in adults and adolescents, developed by World Health Organization (WHO), was first published in 2002, simplified in 2003 and was updated in 2006. The guideline continues to follow the principles of a public health approach, aiming to optimize outcomes, including the quality of life and survival, of people living with HIV (PLHIV), and to act as a reference tool for countries to adopt and adapt according to their national circumstances.

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Regional Workshop on Strengthening ART Data Use in Asia and the Pacific. USAID and WHO (2009)Antiretroviral treatment (ART) is extending the lives of people living with HIV (PLHIV). Though ART has become more widely accessible globally since the early 1990s, getting antiretroviral drugs (ARV) to those who need it most continues to be a challenge. As access increases, so does the need to assure that systems are in place to report on outputs and outcomes in a timely manner. Such data are vital to ART programs, as not only do they assist in tracking progress towards achieving global goals, but they also inform the day- to-day implementation of treatment programs.

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Factsheet N°4: Anti‐Retroviral Therapy (ART) Services in Nepal. National Centre for AIDS and STD Control Teku, Kathmandu (2009)Facts and Figures on ART in Nepal: - Anti‐retroviral treatment started in Nepal in February 2004 from Teku Hospital. - Government is providing free of cost ART service for all those in need. - There is a National ART Guidelines and SOP for the clinical management of ART in Nepal.

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Excellent Outcomes among HIV+ Children on ART, but Unacceptably High Pre-ART Mortality. Raguenaud ME, Isaakidis P, Zachariah R, et al (2009)Background: Although HIV program evaluations focusing on mortality on ART provide important evidence on treatment effectiveness, they do not asses overall HIV program performance because they exclude patients who are eligible but not started on ART for whatever reason. The objective of this study was to measure mortality that occurs both pre-ART and during ART among HIVpositive children enrolled in two HIV-programs in Cambodia.

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Five-Year Experience with Scaling-Up Access to Antiretroviral Treatment in an HIV Care Programme. Thai S, Koole O, Ros PU, et al (2009)To evaluate a 5-year HIV care programme (2003–2007) in the Sihanouk Hospital Center of HOPE, Phnom Penh, Cambodia. Analysis of routine programme indicators per year: number of new patients, active patients, antiretroviral therapy (ART) coverage in the cohort, mortality and loss to follow-up. Comparison of mortality before and after the start of ART using Kaplan–Meier survival curves. Analysis of risk factors using Cox regression for the combined endpoint of mortality and loss to follow-up in patients on ART.

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