ArticlePloS one2015
Sex Differences in Antiretroviral Therapy Initiation in Pediatric HIV Infection.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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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
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Explaining inequity in knowledge, attitude, and services related to HIV/AIDS: a systematic review.BMC public health · 2024Pooled it
- Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission.Nature communications · 2020Pooled it
- Dynamics of Intact and Defective Human Immunodeficiency Virus Type 1 (HIV-1) Proviruses During Decades of Suppressive Antiretroviral Treatment in Young Adults With Perinatal HIV.The Journal of infectious diseases · 2026Article
- Long-term non-progression in children with HIV: estimates from international cohort data.AIDS (London, England) · 2025Article
- Viremic non-progression in HIV/SIV infection: A tied game between virus and host.Cell reports. Medicine · 2025Review
- Evolution of CD4 T-Cell Count With Age in a Cohort of Young People Growing Up With Perinatally Acquired Human Immunodeficiency Virus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Past and current status of adolescents living with HIV in South Africa, 2005-2017.BMC research notes · 2022Article
- Two Distinct Mechanisms Leading to Loss of Virological Control in the Rare Group of Antiretroviral Therapy-Naive, Transiently Aviremic Children Living with HIV.Journal of virology · 2022Article
- Distinct epigenetic profiles in children with perinatally-acquired HIV on antiretroviral therapy.Scientific reports · 2019Article
- HBV vaccination and PMTCT as elimination tools in the presence of HIV: insights from a clinical cohort and dynamic model.BMC medicine · 2019Article
- Strong sex bias in elite control of paediatric HIV infection.AIDS (London, England) · 2019Article
- Hepatitis virus (HCV) diagnosis and access to treatment in a UK cohort.BMC infectious diseases · 2018Article
- Malnutrition in HIV-Infected Children Is an Indicator of Severe Disease with an Impaired Response to Antiretroviral Therapy.AIDS research and human retroviruses · 2018Observational
- Clinical characteristics of pediatric HIV-1 patients treated with first-line antiretroviral therapy in Vietnam: a nested case-control study.International journal of public health · 2017Article
- Higher retention and viral suppression with adolescent-focused HIV clinic in South Africa.PloS one · 2017Article
- Paediatric HIV infection: the potential for cure.Nature reviews. Immunology · 2016Review
- Role of HLA Adaptation in HIV Evolution.Frontiers in immunology · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 6 institutions in 4 countries.
Funding
Abstract
The incidence and severity of infections in childhood is typically greater in males. The basis for these observed sex differences is not well understood, and potentially may facilitate novel approaches to reducing disease from a range of conditions. We here investigated sex differences in HIV-infected children in relation to antiretroviral therapy (ART) initiation and post-treatment outcome. In a South African cohort of 2,101 HIV-infected children, we observed that absolute CD4+ count and CD4% were significantly higher in ART-naïve female, compared to age-matched male, HIV-infected children. Absolute CD4 count and CD4% were also significantly higher in HIV-uninfected female versus male neonates. We next showed that significantly more male than female children were initiated on ART (47% female); and children not meeting criteria to start ART by >5 yrs were more frequently female (59%; p<0.001). Among ART-treated children, immune reconstitution of CD4 T-cells was more rapid and more complete in female children, even after adjustment for pre-ART absolute CD4 count or CD4% (p=0.011, p=0.030, respectively). However, while ART was initiated as a result of meeting CD4 criteria less often in females (45%), ART initiation as a result of clinical disease in children whose CD4 counts were above treatment thresholds occurred more often in females (57%, p<0.001). The main sex difference in morbidity observed in children initiating ART above CD4 thresholds, above that of TB disease, was as a result of wasting and stunting observed in females with above-threshold CD4 counts (p=0.002). These findings suggest the possibility that optimal treatment of HIV-infected children might incorporate differential CD4 treatment thresholds for ART initiation according to sex.
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Registered trials
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