ArticleJournal of acquired immune deficiency syndromes (1999)2010
Short-term risk of HIV disease progression and death in Ugandan children not eligible for antiretroviral therapy.
Article in Journal of acquired immune deficiency syndromes (1999), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- They are likely to be there: using a family-centered index testing approach to identify children living with HIV in Kenya.International journal of STD & AIDS · 2020Article
- Article
- Beyond early infant diagnosis: case finding strategies for identification of HIV-infected infants and children.AIDS (London, England) · 2013Review
- Paediatric HIV care in sub-Saharan Africa: clinical presentation and 2-year outcomes stratified by age group.Tropical medicine & international health : TM & IH · 2013Article
- Risk factors for pre-treatment mortality among HIV-infected children in rural Zambia: a cohort study.PloS one · 2011Article
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Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundIncreasing numbers of HIV-infected children not yet eligible for antiretroviral therapy (ART) are entering health care in Africa. We sought to characterize the risk of short-term disease progression in this population.
methodsIn a cohort of HIV-infected ART-naive and -ineligible Ugandan children older than 1 year, the rates of clinical/immunologic progression within 2 years were assessed using Kaplan-Meier survival analysis and multivariate Cox proportional-hazards modeling.
resultsAmong 192 children (mean age: 6.4 years, CD4%:25), 19% progressed within 2 years by World Health Organization stage 3/4 event (n = 22), death (n = 3), or World Health Organization-defined CD4 threshold for ART initiation (n = 12). Significant univariate predictors were CD4% [hazard ratio (HR) = 2.0 per 10% decrease, P = 0.005], HIV RNA level (HR = 2.4 per log10 increase, P = 0.002), male gender (HR = 2.0, P = 0.04), age < 3 years (HR = 3.7, P = 0.001), CD4 activation (%CD4+ CD38+ HLADR+) (HR = 1.6 per 10% increase, P = 0.05), and CD8 activation (%CD8+ CD38+ HLADR+) (HR = 1.3 per 10% increase, P = 0.05] (HR = 1.3, P = 0.5). In multivariate analysis, CD4% (HR = 2.0, P = 0.034), HIV RNA level (HR = 1.8, P = 0.013), and age < 3 years (HR = 3.0, P = 0.008) were independently predictive. Children with HIV RNA >10 copies per milliliter and CD4% <25 had progression rates of 29% (1 year) and 34% (2 years).
conclusionsEven with frequent CD4 monitoring, HIV-infected Ugandan children experienced significant clinical events while ineligible for ART per WHO 2006 guidelines.
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