Unknown

Dataset Information

0

Predictors of Mortality in a Clinic Cohort of HIV-1 Infected Children Initiated on Antiretroviral Therapy in Jos, Nigeria.


ABSTRACT: Background:Mortality among human immunodeficiency virus-1 (HIV-1) infected children initiated on antiretroviral therapy (ART) though on a decline still remains high in resource-limited countries (RLC). Identifying baseline factors that predict mortality could allow their possible modification in order to improve pediatric HIV care and reduce mortality. Methods:We conducted a retrospective cohort study analyzing data on 691 children, aged 2 months-15 years, diagnosed with HIV-1 infection and initiated on ART between July 2005 and March 2013 at the pediatric HIV clinic of Jos University Teaching Hospital. Lost to follow-up children were excluded from the analyses. A multivariate Cox proportional hazards model was fitted to identify predictors of mortality. Results:Median follow-up time for the 691 children initiated on ART was 4.4 years (interquartile range (IQR), 1.8-5.9) and at the end of 2752 person-years of follow-up, 32 (4.6%) had died and 659 (95.4%) survived. The mortality rate was 1.0 per 100 child-years of follow-up period. The median age of those who died was about two times lower than that of survivors [1.7 years (IQR, 0.6-3.6) versus 3.9 years (IQR, 3.9-10.3), p<0.001]. On unadjusted Cox regression, the risk of dying was about three and half times more in children <5 years of age compared to those >5 years (p=0.02) Multivariate modeling identified age as the main predictor of death with mortality decreasing by 24% for every 1 year increase in age (Adjusted Hazard Ratio (AHR)=0.76 [0.62-0.94], p=0.013. Conclusion:The lower mortality rate for our study suggests that even in RLC, mortality rates could be reduced given a good standard of care. Early initiation of ART in younger children with close monitoring during follow-up could further reduce mortality.

SUBMITTER: Ebonyi AO 

PROVIDER: S-EPMC6223308 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

altmetric image

Publications

Predictors of Mortality in a Clinic Cohort of HIV-1 Infected Children Initiated on Antiretroviral Therapy in Jos, Nigeria.

Ebonyi Augustine O AO   Oguche Stephen S   Meloni Seema T ST   Sagay Solomon A SA   Kyriacou Demetrios N DN   Achenbach Chad J CJ   Agbaji Oche O OO   Oyebode Tinuade A TA   Okonkwo Prosper P   Idoko John A JA   Kanki Phyllis J PJ  

Journal of AIDS & clinical research 20141220 12


<h4>Background</h4>Mortality among human immunodeficiency virus-1 (HIV-1) infected children initiated on antiretroviral therapy (ART) though on a decline still remains high in resource-limited countries (RLC). Identifying baseline factors that predict mortality could allow their possible modification in order to improve pediatric HIV care and reduce mortality.<h4>Methods</h4>We conducted a retrospective cohort study analyzing data on 691 children, aged 2 months-15 years, diagnosed with HIV-1 inf  ...[more]

Similar Datasets

| S-EPMC2887829 | biostudies-other
| S-EPMC5345814 | biostudies-literature
| S-EPMC4736127 | biostudies-other
| S-EPMC6609091 | biostudies-literature
| S-EPMC3581031 | biostudies-literature
| S-EPMC9758350 | biostudies-literature
| S-EPMC2950021 | biostudies-literature
| S-EPMC8322087 | biostudies-literature
| S-EPMC2925143 | biostudies-literature
| S-EPMC5106089 | biostudies-other