Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis
Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis
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DOI：
10.1016/s0140-6736(04)17140-7
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发表时间：
2004-10-02
期刊：
影响因子：
168.9
通讯作者：
Dabis, F
中科院分区：
文献类型：
--
作者：
Newell, ML;Coovadia, H;Dabis, F
背景：艾滋病毒在很大程度上导致儿童死亡，但这些死亡背后的因素没有得到充分描述。根据7项随机母婴传播（MTCT）干预试验的个人数据，我们估计了感染艾滋病毒的母亲所生非洲儿童的死亡率，并分析了选定的风险因素。方法早期HIV感染定义为4周龄前HIV- pcr检测阳性；在4周龄或4周龄后进行PCR阴性检测，然后进行阳性检测。死亡率表示为每1000儿童年。我们调查了孕产妇健康、婴儿艾滋病毒感染、喂养方式和感染年龄对死亡率的影响，采用Cox比例风险模型进行评估，并允许在按地理分组的试验中存在随机效应。结果3468例患儿中有378例（11%）死亡。到1岁时，估计有35.2%的感染儿童和4.9%的未感染儿童死亡；到2岁时，分别有52.5%和7.6%的儿童死亡。死亡率因地理区域而异，并与产妇死亡（校正优势比2.27,95% CI 1.62-3.19）、CD4+细胞计数相关
Background HIV contributes substantially to child mortality, but factors underlying these deaths are inadequately described. With individual data from seven randomised mother-to-child transmission (MTCT) intervention trials, we estimate mortality in African children born to HIV-infected mothers and analyse selected risk factors.Methods Early HIV infection was defined as a positive HIV-PCR test before 4 weeks of age; and late infection by a negative PCR test at or after 4 weeks of age, followed by a positive test. Mortality rate was expressed per 1000 child-years. We investigated the effect of maternal health, infant HIV infection, feeding practices, and age at acquisition of infection on mortality assessed with Cox proportional hazards models, and allowed for random effects for trials grouped geographically.Findings 378 (11%) of 3468 children died. By age 1 year, an estimated 35.2% infected and 4.9% unindected children will have died; by 2 years of age, 52.5% and 7.6% will have died, respectively. Mortality varied by geographical region, and was associated with maternal death (adjusted odds ratio 2.27, 95% CI 1.62-3.19), CD4+ cell counts