Mortality risk in selenium-deficient HIV-positive children
Mortality risk in selenium-deficient HIV-positive children
复制标题
DOI：
10.1097/00042560-199904150-00015
复制
发表时间：
1999-04-15
期刊：
影响因子：
--
通讯作者：
Baum, MK
中科院分区：
文献类型：
--
作者：
Campa, A;Shor-Posner, G;Baum, MK
目的：确定特定营养因素对 HIV-1 感染儿童疾病进展和生存的独立贡献。人群：1990 年 10 月至 12 月从佛罗里达州迈阿密杰克逊纪念儿科免疫学诊所招募围产期暴露于病毒且有症状的 HIV 感染儿童 (N = 24)，并观察 5 年。方法：通过 CD4 细胞计数测量免疫状态：使用血清白蛋白和血浆微量元素包括铁、锌和硒。 Cox比例风险回归模型用于评估这些参数与生存的关系。统计模型中考虑使用抗逆转录病毒治疗，死亡年龄被认为是疾病进展的参数。结果：在研究过程中，12 名儿童死于 HIV 相关原因，最终的 Cox 多变量分析表明，在评估的变量中，只有 CD4 细胞计数低于 200（风险比 [RR] = 7.05；95% 置信区间 [CI]，1.87-26.5）；p = .0041，血浆硒水平低（RR = 5.96；95% CI，1.32-26.81；p = 0.02）与死亡率显着且独立相关。在死亡儿童中，硒水平低（低于或等于 85 μg/L）的儿童死亡年龄较小，表明疾病进展更快。结论：在儿科 HIV 感染中，血浆硒水平低是死亡率的独立预测因子，并且似乎与疾病进展更快相关。
Objective: To determine the independent contribution of specific nutritional factors on disease progression and survival in HIV-1-infected children.Population: HIV-infected children (N = 24), who were perinatally exposed to the virus and symptomatic, were recruited between October and December of 1990 from the Jackson Memorial Pediatric Immunology Clinic, Miami, Florida, and observed for 5 years.Methods: Immune status was measured by CD4 cell count: nutritional status was determined using serum albumin and plasma trace elements including iron, zinc, and selenium. Cox proportional hazards regression models were used to evaluate the relationship of these parameters to survival. Use of antiretroviral treatment was considered in the statistical model, and age at death was considered a parameter of disease progression.Results: Over the course of the study, 12 children died of HIV-related causes, The final Cox multivariate analysis indicated that, of the variables evaluated, only CD4 cell count below 200 (risk ratio [RR] = 7.05; 95% confidence interval [CI], 1.87-26.5);p =.0041, and low levels of plasma selenium (RR = 5.96; 95% CI, 1.32-26.81; p =.02) were significantly and independently related to mortality. Among the children who died, those with low selenium levels (less than or equal to 85 mu g/L), died at a younger age, suggesting more rapid disease progression.Conclusions: In pediatric HIV-infection, low plasma level of selenium is an independent predictor of mortality, and appears to be associated with faster disease progression.