ArticleThe Pediatric infectious disease journal2014
Incidence of World Health Organization stage 3 and 4 events, tuberculosis and mortality in untreated, HIV-infected children enrolling in care before 1 year of age: an IeDEA (International Epidemiologic Databases To Evaluate AIDS) East Africa regional analysis.
Article in The Pediatric infectious disease journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- The impact of HIV and antiretroviral therapy on TB risk in children: a systematic review and meta-analysis.Thorax · 2017Pooled it
- Validation and calibration of a computer simulation model of pediatric HIV infection.PloS one · 2013Trial
- Characteristics and mortality of children living with HIV/TB coinfection in a tertiary hospital in a resource-limited setting.BMC infectious diseases · 2025Observational
- High Incidence of Tuberculosis in Young Children Living With HIV in the Western Cape, South Africa.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Article
- Iron supplementation and paediatric HIV disease progression: a cohort study among children receiving routine HIV care in Dar es Salaam, Tanzania.International journal of epidemiology · 2022Article
- Article
- Cost-effectiveness of Routine Provider-Initiated Testing and Counseling for Children With Undiagnosed HIV in South Africa.Open forum infectious diseases · 2022Article
- Factors associated with North-South research collaboration focusing on HIV/AIDS: lessons from ClinicalTrials.gov.AIDS research and therapy · 2021Article
- Addressing Pediatric HIV Pretreatment Drug Resistance and Virologic Failure in Sub-Saharan Africa: A Cost-Effectiveness Analysis of Diagnostic-Based Strategies in Children ≥3 Years Old.Diagnostics (Basel, Switzerland) · 2021Article
- Time to Develop and Predictors for Incidence of Tuberculosis among Children Receiving Antiretroviral Therapy.Tuberculosis research and treatment · 2021Article
- Optimizing infant HIV diagnosis with additional screening at immunization clinics in three sub-Saharan African settings: a cost-effectiveness analysis.Journal of the International AIDS Society · 2021Article
- Strengthening Existing Laboratory-Based Systems vs. Investing in Point-of-Care Assays for Early Infant Diagnosis of HIV: A Model-Based Cost-Effectiveness Analysis.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Incidence of tuberculosis in children on antiretroviral therapy: a retrospective cohort study.BMC research notes · 2018Article
- The value of confirmatory testing in early infant HIV diagnosis programmes in South Africa: A cost-effectiveness analysis.PLoS medicine · 2017Article
- Clinical Impact and Cost-effectiveness of Diagnosing HIV Infection During Early Infancy in South Africa: Test Timing and Frequency.The Journal of infectious diseases · 2016Article
- Obstetrical, maternal characteristics and outcome of HIV-infected rapid progressor infants at Yaounde: a retrospective study.Translational pediatrics · 2016Article
- Family, Community, and Health System Considerations for Reducing the Burden of Pediatric Sickle Cell Disease in Uganda Through Newborn Screening.Global pediatric health · 2016Article
- Cost-effectiveness of first-line antiretroviral therapy for HIV-infected African children less than 3 years of age.AIDS (London, England) · 2015Article
- Tuberculosis: opportunities and challenges for the 90-90-90 targets in HIV-infected children.Journal of the International AIDS Society · 2015Review
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 3 countries.
Funding
Abstract
backgroundFew studies have reported CD4%- and age-stratified rates of World Health Organization Stage 3 (WHO3) events, World Health Organization Stage 4 (WHO4) events, tuberculosis (TB) and mortality in HIV-infected infants before initiation of antiretroviral therapy.
methodsHIV-infected children enrolled before 1 year of age in the International Epidemiologic Databases to Evaluate AIDS East Africa region (October 1, 2002, to November, 2008) were included. We estimated incidence rates of earliest clinical event (WHO3, WHO4 and TB), before antiretroviral therapy initiation per local guidelines, stratified by current age (< or ≥6 months) and current CD4% (<15%, 15-24%, ≥25%). CD4%-stratified mortality rates were estimated separately for children who did not experience a clinical event ("background" mortality) and for children who experienced an event, including "acute" mortality (≤30 days post event) and "later" mortality (>30 days post event).
resultsAmong 847 children (median enrollment age: 4.8 months; median pre-antiretroviral therapy follow up: 10.8 months; 603 (71%) with ≥1 CD4% recorded), event rates were comparable for those aged <6 and ≥6 months. Current CD4% was associated with risk of WHO4 events for children <6 months of age and with all evaluated events for children ≥6 months old (P < 0.05). "Background" mortality was 3.7-8.4/100 person-years (PY). "Acute" mortality (≤30 days post event) was 33.8/100 PY (after TB) and 41.1/100 PY (after WHO3 or WHO4). "Later" mortality (>30 days post event) ranged by CD4% from 4.7 to 29.1/100 PY.
conclusionsIn treatment-naïve, HIV-infected infants, WHO3, WHO4 and TB events were common before and after 6 months of age and led to substantial increases in mortality. Early infant HIV diagnosis and treatment are critically important, regardless of CD4%.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.