ArticlePediatrics2012
Mortality and clinical outcomes in HIV-infected children on antiretroviral therapy in Malawi, Lesotho, and Swaziland.
Article in Pediatrics, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 5 of them syntheses that pooled it.
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Who cites it
55 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- HIV-related mortality time trends among children and young adolescents on antiretroviral therapy by age, treatment duration, and region: a systematic review and meta-regression analysis.The lancet. HIV · 2025Pooled it
- Determinants of HIV related mortality in African children on antiretroviral therapy: clinical and immunological insights from a systematic review and meta-analysis.AIDS research and therapy · 2025Pooled it
- Incidence density mortality rate among HIV-positive children on antiretroviral therapy in Ethiopia: a systematic review and meta-analysis.BMC public health · 2024Pooled it
- Pooled it
- Implementation of antiretroviral therapy guidelines for under-five children in Tanzania: translating recommendations into practice.Journal of the International AIDS Society · 2015Guideline
- Estimating the costs of adolescent HIV care visits and an intervention to facilitate transition to adult care in Kenya.PloS one · 2024Trial
- "Let's talk about sex": a qualitative study of Rwandan adolescents' views on sex and HIV.PloS one · 2014Trial
- Long-term risk of mortality and loss to follow-up in children and adolescents on antiretroviral therapy in Asia.HIV medicine · 2025Observational
- Predicting mortality within 1 year of ART initiation in children and adolescents living with HIV in sub-Saharan Africa: a retrospective observational cohort study.The Lancet. Global health · 2024Observational
- Long-term effect of antiretroviral therapy on mortality among HIV-positive children and adolescents in China.Heliyon · 2024Article
- Adherence to Antiretroviral Therapy and Associated Factors Among HIV-Infected Children in Public Health Institutions of Adwa, Axum, and Shire Towns of Tigray, Northern Ethiopia: A Cross-Sectional Study.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Article
- Incidence and predictors of attrition among children on antiretroviral therapy at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019: Retrospective follow-up study.SAGE open medicine · 2022Article
- Treatment outcomes among children younger than five years living with HIV in rural Zambia, 2008-2018: a cohort study.BMC pediatrics · 2021Article
- Poor treatment outcomes of children on highly active antiretroviral therapy: protocol for a systematic review and meta-analysis.BMJ open · 2020Article
- Mortality rate among HIV-positive children on ART in Northwest Ethiopia: a historical cohort study.BMC public health · 2020Article
- Observational
- Survival of Children Living With HIV on Art in Zambia: A 13-Years Retrospective Cohort Analysis.Frontiers in public health · 2020Article
- Long-Term Outcomes and Risk Factors for Mortality in a Cohort of HIV-Infected Children Receiving Antiretroviral Therapy in Vietnam.HIV/AIDS (Auckland, N.Z.) · 2020Article
- Premature mortality in children aged 6-9 years with neurological impairments in rural Kenya: a cohort study.The Lancet. Global health · 2019Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
objectiveTo determine mortality and immune status improvement in HIV-infected pediatric patients on antiretroviral treatment (ART) in Malawi, Lesotho, and Swaziland.
methodsWe conducted a retrospective cohort study of patients aged <12 years at ART initiation at 3 sites in sub-Saharan Africa between 2004 and 2009. Twelve-month and overall mortality were estimated, and factors associated with mortality and immune status improvement were evaluated.
resultsIncluded in the study were 2306 patients with an average follow-up time on ART of 2.3 years (interquartile range 1.5-3.1 years). One hundred four patients (4.5%) died, 9.0% were lost to follow-up, and 1.3% discontinued ART. Of the 104 deaths, 77.9% occurred in the first year of treatment with a 12-month mortality rate of 3.5%. The overall mortality rate was 2.25 deaths/100 person-years (95% confidence interval [CI] 1.84-2.71). Increased 12-month mortality was associated with younger age; <6 months (hazard ratio [HR] = 8.11, CI 4.51-14.58), 6 to <12 months (HR = 3.43, CI 1.96-6.02), and 12 to <36 months (HR = 1.92, CI 1.16-3.19), and World Health Organization stage IV (HR = 4.35, CI 2.19-8.67). Immune status improvement at 12 months was less likely in patients with advanced disease and age <12 months.
conclusionsDespite challenges associated with pediatric ART in developing countries, low mortality and good treatment outcomes can be achieved. However, outcomes are worse in younger patients and those with advanced disease at the time of ART initiation, highlighting the importance of early diagnosis and treatment.
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