Opportunistic illnesses in Brazilian children with AIDS results from two national cohort studies, 1983-2007 英文参考文献.docVIP

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Opportunistic illnesses in Brazilian children with AIDS results from two national cohort studies, 1983-2007 英文参考文献.doc

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Opportunistic illnesses in Brazilian children with AIDS results from two national cohort studies, 1983-2007 英文参考文献

Ramosetal.AIDSResearchandTherapy2011,8:23 /content/8/1/23 RESEARCH OpenAccess OpportunisticillnessesinBrazilianchildrenwith AIDS:resultsfromtwonationalcohortstudies, 1983-2007 AlbertoNRamosJr1,LuizaHMatida2,NormanHearst3andJorgHeukelbach1* Abstract Background:HAARThassignificantlyreducedAIDS-relatedmorbidityinchildren.However,limitedevidenceis availablefromdevelopingcountriesregardingpatternsofopportunisticillnesses.Wedescribetheseeventsand theirassociatedfactorsinchildrenwithAIDSinBrazil. Methods:Thisstudyisbasedontworepresentativeretrospectivemulti-centercohortsincludingatotal1,859 childrenwithAIDS,infectedviamother-to-childtransmission(MTCT),between1983-2002.Opportunisticillnesses weredescribedandanalyzedovertime.Theassociationofdemographic,clinicalandoperationaldatawiththe occurrenceofopportunisticdiseaseswasassessed. Results:Intotal,1,218(65.5%)hadatleastoneeventofanopportunisticdisease.Variablessignificantlyassociated withoccurrenceoftheseeventsincluded:regionofresidence(OR2.68-11.33,ascomparedtotheNorthernregion), age1yearatdiagnosis(OR2.56,95%CI1.81-3.61,p0.001),andnon-performanceofMTCTpreventionmeasures (OR1.58,95%CI1.21-2.07,p0.001).ProtectivefactorsincludedyearofHIVdiagnosisintheHAARTera(OR0.34, 95%CI0.15-0.76,p=0.009)andARTuse(OR0.58,95%CI0.44-0.77,p0.001).Inbothperiodsbacterialinfections representedthemostcommonopportunisticevents(58.6vs.34.7%;p0.001),followedbyPneumocystisjirovecii pneumonia(21.9vs.13.2%;p0.001),andbacterialmeningitis/sepsis(16.8vs.7.4%;p0.001). Conclusions:Despitethesignificantreductioninrecentyears,opportunisticillnessesarestillcommoninBrazilian childrenwithAIDSintheHAARTera,especiallybacterialdiseases.Thedatareinforcetheneedforscalingup preventionofMTCT,earlydiagnosisofinfection,andimprovementofcomprehensivepediatriccare. Background The adoption of highly active antiretroviral therapy Over the past 15 years, both morbidity and mortality (HAART) also hashadanimportant role inmodifying associated with human immunodeficiency virus