Evidence map›Paper›PMID 27481854›Full record

ArticleJournal of the Pediatric Infectious Diseases Society2017

High Viremia and Wasting Before Antiretroviral Therapy Are Associated With Pneumonia in Early-Treated HIV-Infected Kenyan Infants.

Geetha Sridharan, Dalton Wamalwa, Grace John-Stewart, Kenneth Tapia, Agnes Langat, Helen Moraa Okinyi, Judith Adhiambo, Daisy Chebet, Elizabeth Maleche-Obimbo, Catherine J Karr and 1 more

Registry-linked trialOpen access · bronzeAbstract read
In one paragraph

Article in Journal of the Pediatric Infectious Diseases Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00428116 (Optimizing Pediatric HIV-1 Treatment, Nairobi, Kenya), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT00428116 naterminatednot on this map

Optimizing Pediatric HIV-1 Treatment, Nairobi, Kenya (0-4.5 Month Randomized Controlled Trial)

TypeinterventionalSponsorUniversity of WashingtonRan2007 to 2014Enrolled140ConditionsHIV InfectionsArmsHAART
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 2 countries.

Geetha SridharanDepartment of Global Health, University of Washington, Seattle.
Dalton WamalwaDepartment of Paediatrics and Child Health, University of Nairobi, Kenya.
Grace John-StewartDepartment of Global Health, University of Washington, Seattle.
Kenneth TapiaDepartment of Global Health, University of Washington, Seattle.
Agnes LangatDepartment of Paediatrics and Child Health, University of Nairobi, Kenya.
Helen Moraa OkinyiDepartment of Paediatrics and Child Health, University of Nairobi, Kenya.
Judith AdhiamboDepartment of Paediatrics and Child Health, University of Nairobi, Kenya.
Daisy ChebetDepartment of Paediatrics and Child Health, University of Nairobi, Kenya.
Elizabeth Maleche-ObimboDepartment of Paediatrics and Child Health, University of Nairobi, Kenya.
Catherine J KarrDepartment of Pediatrics, University of Washington, Seattle.
Sarah Benki-NugentDepartment of Global Health, University of Washington, Seattle.
University of Nairobi · KEUniversity of Washington · US

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI EDWIN ROBERTO ORELLANA · 1988 to 2026
$104.9M
XENOBIOTIC BIOTRANSFORMATION AND DISPOSITIONP30ES007033 · NIEHS · UNIVERSITY OF WASHINGTON · PI Sheela Sathyanarayana · 1995 to 2026
$42.5M
Urgent Versus Post-Stabilization ART in HIV+ Children with Severe Co-infectionsR01HD023412 · NICHD · UNIVERSITY OF WASHINGTON · PI Grace C. John-Stewart, DALTON CHEKOKO WAMALWA · 1987 to 2026
$12.2M
Pediatric HIV-1 in Africa: Pathogenesis and ManagementK24HD054314 · NICHD · UNIVERSITY OF WASHINGTON · PI JOHN-STEWART, GRACE C. · 2006 to 2016
$1.2M
Impact of HIV, immune activation, and ART on child neurodevelopment in KenyaK01NS080637 · NINDS · UNIVERSITY OF WASHINGTON · PI BENKI-NUGENT, SARAH F. · 2012 to 2016
$848k
NIAID NIH HHS P30 AI027757NICHD NIH HHS K24 HD054314NICHD NIH HHS R01 HD023412NIEHS NIH HHS P30 ES007033NINDS NIH HHS K01 NS080637
6 · The paper itself

Abstract

backgroundHuman immunodeficiency virus (HIV)-infected children are particularly susceptible to acute respiratory infections (ARIs). We determined incidence and cofactors for ARIs in HIV-infected infants receiving antiretroviral therapy (ART).

methodsHuman immunodeficiency virus-infected infants initiated ART at ≤12 months of age and were observed monthly for 2 years in Nairobi. Acute respiratory infection rates and cofactors were determined using Andersen-Gill models, allowing for multiple events per infant.

resultsAmong 111 HIV-infected infants, median age at ART initiation was 4.5 months. Pre-ART median CD4% was 19%, and 29% had wasting. During 24-months follow-up while on ART, upper respiratory infection (URI) and pneumonia rates were 122.6 and 34.7 per 100 person-years (py), respectively. Infants with higher pre-ART viral load (VL) (plasma HIV ribonucleic acid [RNA] ≥7 log10 copies/mL) had 4.12-fold increased risk of pneumonia (95% confidence interval [CI], 2.17-7.80), and infants with wasting (weight-for-height z-score < -2) had 2.87-fold increased risk (95% CI, 1.56-5.28). Infants with both high pre-ART VL and wasting had a higher pneumonia rate (166.8 per 100 py) than those with only 1 of these risk factors (44.4 per 100 py) or neither (17.0 per 100 py). Infants with exposure to wood fuel had significantly higher risk of URI (hazard ratio [HR] = 1.82; 95% CI, 1.44-2.28) and pneumonia (HR = 3.31; 95% CI, 1.76-6.21).

conclusionsIn early ART-treated HIV-infected infants, higher HIV RNA and wasting before ART were independent risk factors for pneumonia. Wood fuel use was associated with URI and pneumonia. Additional data on air pollution and respiratory outcomes in HIV-infected children may help optimize interventions to improve their lung health.

Indexed as

Anti-HIV AgentsFemaleHIV InfectionsHIV Wasting SyndromeHumansInfantKenyaMalePneumoniaRespiratory Tract InfectionsRisk FactorsViremiaAnti-HIV Agentsacute respiratory infectionsHIVhome air pollutioninfantspneumonia

Identifiers

PMID27481854
PMCPMC5907857
OpenAlexW2484857841

What OpenQuestion holds

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Registered trials

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.