ArticleJournal of acquired immune deficiency syndromes (1999)2015
Immunodeficiency in children starting antiretroviral therapy in low-, middle-, and high-income countries.
Article in Journal of acquired immune deficiency syndromes (1999), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01418014 (Adolescent Master Protocol), which is not on this map. Cited by 40 papers, 3 of them syntheses that pooled it.
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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.
Adolescent Master Protocol
Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Socioeconomic status and mortality among dialysis patients: a systematic review and meta-analysis.International urology and nephrology · 2019Pooled it
- Outcomes of HIV-positive patients lost to follow-up in African treatment programmes.Tropical medicine & international health : TM & IH · 2017Pooled it
- Implementation of antiretroviral therapy guidelines for under-five children in Tanzania: translating recommendations into practice.Journal of the International AIDS Society · 2015Guideline
- Documenting HIV service delivery and adoption of evidence-based practices in HIV care programs: A protocol for a cross-sectional survey of HIV clinics participating in the International epidemiology Databases to Evaluate AIDS (IeDEA).medRxiv : the preprint server for health sciences · 2026Article
- Trends of severe HIV disease and mortality among children in rural Tanzania.HIV medicine · 2025Article
- Survival status and its predictors among undernourished children on antiretroviral therapy in Bahir Dar city, Northwest Ethiopia, 2010 - 2020, a multicenter retrospective cohort study.BMC pediatrics · 2024Article
- The changing characteristics of a cohort of children and adolescents living with HIV at antiretroviral therapy initiation in Asia.PloS one · 2023Article
- Effects of National Adoption of Treat-All Guidelines on Pre-Antiretroviral Therapy (ART) CD4 Testing and Viral Load Monitoring After ART initiation: A Regression Discontinuity Analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Improving Services for HIV-Exposed Infants in Zambia and Cameroon Using a Quality Improvement Collaborative Approach.Global health, science and practice · 2021Article
- Cryptococcal Immune Reconstitution Inflammatory Syndrome: From Blood and Cerebrospinal Fluid Biomarkers to Treatment Approaches.Life (Basel, Switzerland) · 2021Review
- Impact of Universal Antiretroviral Treatment Eligibility on Rapid Treatment Initiation Among Young Adolescents with Human Immunodeficiency Virus in Sub-Saharan Africa.The Journal of infectious diseases · 2020Article
- Article
- Clinico-Immunological Status and Neurocognitive Function of Perinatally Acquired HIV-Positive Children on cART: A Cross-Sectional Correlational Study in South Africa.Frontiers in neurology · 2020Article
- Temporal Trends in Co-trimoxazole Use Among Children on Antiretroviral Therapy and the Impact of Co-trimoxazole on Mortality Rates in Children Without Severe Immunodeficiency.Journal of the Pediatric Infectious Diseases Society · 2019Article
- Factors associated with non-attendance at scheduled infant follow-up visits in an observational cohort of HIV-exposed infants in South Africa, 2012-2014.BMC infectious diseases · 2019Observational
- Health provider training is associated with improved engagement in HIV care among adolescents and young adults in Kenya.AIDS (London, England) · 2019Article
- Long-term survival outcomes of HIV infected children receiving antiretroviral therapy: an observational study from Zambia (2003-2015).BMC public health · 2019Observational
- Traversing the cascade: urgent research priorities for implementing the 'treat all' strategy for children and adolescents living with HIV in sub-Saharan Africa.Journal of virus eradication · 2018Article
- IeDEA-WHO Research-Policy Collaboration: contributing real-world evidence to HIV progress reporting and guideline development.Journal of virus eradication · 2018Article
- The contribution of observational studies in supporting the WHO 'treat all' recommendation for HIV/AIDS.Journal of virus eradication · 2018Article
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Authors and funding
15 authors at 10 institutions in 7 countries.
Funding
Abstract
backgroundThe CD4 cell count or percent (CD4%) at the start of combination antiretroviral therapy (cART) is an important prognostic factor in children starting therapy and an important indicator of program performance. We describe trends and determinants of CD4 measures at cART initiation in children from low-, middle-, and high-income countries.
methodsWe included children aged <16 years from clinics participating in a collaborative study spanning sub-Saharan Africa, Asia, Latin America, and the United States. Missing CD4 values at cART start were estimated through multiple imputation. Severe immunodeficiency was defined according to World Health Organization criteria. Analyses used generalized additive mixed models adjusted for age, country, and calendar year.
resultsA total of 34,706 children from 9 low-income, 6 lower middle-income, 4 upper middle-income countries, and 1 high-income country (United States) were included; 20,624 children (59%) had severe immunodeficiency. In low-income countries, the estimated prevalence of children starting cART with severe immunodeficiency declined from 76% in 2004 to 63% in 2010. Corresponding figures for lower middle-income countries were from 77% to 66% and for upper middle-income countries from 75% to 58%. In the United States, the percentage decreased from 42% to 19% during the period 1996 to 2006. In low- and middle-income countries, infants and children aged 12-15 years had the highest prevalence of severe immunodeficiency at cART initiation.
conclusionsDespite progress in most low- and middle-income countries, many children continue to start cART with severe immunodeficiency. Early diagnosis and treatment of HIV-infected children to prevent morbidity and mortality associated with immunodeficiency must remain a global public health priority.
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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.