Predictors of mortality among HIV-infected children receiving highly active antiretroviral therapy.

Autor: Njom Nlend AE; Department of pediatrics, National Social Insurance Fund Hospital, centre hospitalier d'ESSOS, PO Box 5777, Yaoundé, Cameroon. Electronic address: anne.njom@gmail.com., Loussikila AB; École polytechnique Yaoundé, Specialized Masters in Mathematics, Yaoundé, Cameroon. Electronic address: branly.loussikila@gmail.com.
Jazyk: angličtina
Zdroj: Medecine et maladies infectieuses [Med Mal Infect] 2017 Feb; Vol. 47 (1), pp. 32-37. Date of Electronic Publication: 2016 Sep 05.
DOI: 10.1016/j.medmal.2016.07.003
Abstrakt: Background and Objectives: The mortality rate of HIV-infected children can be reversed under highly active antiretroviral therapy (HAART). The impact of HAART on the mortality of HIV-infected children in Cameroon has not been extensively documented. We aimed to measure the mortality rate of HIV-infected children under HAART and to identify predictive factors of mortality.
Methods: Retrospective cohort study of 221 children initiated on HAART from 2005 to 2009 and followed-up until 2013. Survival data was analyzed using Kaplan Meier method and Cox regression model to identify independent predictors of child mortality on HAART.
Results: Overall, 9.9% of children (n=22) died over a follow-up period of 755 child-years (mortality of 2.9 per 100 child-years); 70% of deaths occurred during the first six months of HAART. The probability of survival after four years of treatment was 88.7% (95% CI=[84.2-93.3]). During the multivariate analysis of baseline variables, we observed that the WHO clinical stages III and IV (HR: 3.55 [1.09-13.6] and HR: 7.7 [3.07-31.2]) and age≤1year at HAART initiation were independently associated with death (HR: 2.1 [1.01-5.08]). Neither orphanhood, baseline CD4 count or hemoglobin level nor low nutritional status predicted death in this cohort.
Conclusion: The mortality of children receiving HAART was low after five years of follow-up and it was strongly associated with WHO stages III and IV and a younger age at treatment initiation.
(Copyright © 2016 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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