Predictors of Mortality in a Clinic Cohort of HIV-1 Infected Children Initiated on Antiretroviral Therapy in Jos, Nigeria.
Predictors of Mortality in a Clinic Cohort of HIV-1 Infected Children Initiated on Antiretroviral Therapy in Jos, Nigeria.
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DOI：
10.4172/2155-6113.1000403
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发表时间：
2014-01-01
期刊：
影响因子：
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通讯作者：
Kanki, Phyllis J
中科院分区：
文献类型：
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作者：
Ebonyi, Augustine O;Oguche, Stephen;Kanki, Phyllis J
背景：在资源有限国家（RLC），开始接受抗逆转录病毒治疗（ART）的人类免疫缺陷病毒-1（HIV-1）感染儿童的死亡率虽然有所下降，但仍然很高。确定预测死亡率的基线因素可以对其进行可能的修改，以改善儿童艾滋病毒护理并降低死亡率。 方法：我们进行了一项回顾性队列研究，分析了 2005 年 7 月至 2013 年 3 月期间在乔斯大学教学医院儿科艾滋病毒诊所诊断为 HIV-1 感染并开始接受 ART 的 691 名 2 个月至 15 岁儿童的数据。失访儿童被排除在分析之外。采用多变量 Cox 比例风险模型来确定死亡率的预测因素。 结果：开始接受 ART 的 691 名儿童的中位随访时间为 4.4 年（四分位距 (IQR)，1.8-5.9），在 2752 人年随访结束时，32 人 (4.6%) 死亡，659 人 (95.4%) 存活。随访期间死亡率为每 100 儿童年 1.0 人。死亡者的中位年龄比幸存者低约两倍 [1.7 岁 (IQR, 0.6-3.6) 对比 3.9 岁 (IQR, 3.9-10.3)，p
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