predictors of mortality in hiv-1 infected children on antiretroviral therapy in kenya a prospective cohort预测hiv - 1感染儿童的死亡率在抗逆转录病毒疗法在肯尼亚一个前瞻性群组.pdfVIP

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predictors of mortality in hiv-1 infected children on antiretroviral therapy in kenya a prospective cohort预测hiv - 1感染儿童的死亡率在抗逆转录病毒疗法在肯尼亚一个前瞻性群组.pdf

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predictors of mortality in hiv-1 infected children on antiretroviral therapy in kenya a prospective cohort预测hiv - 1感染儿童的死亡率在抗逆转录病毒疗法在肯尼亚一个前瞻性群组

Wamalwa et al. BMC Pediatrics 2010, 10:33 /1471-2431/10/33 R E S E A R C H A R T I C L E Open Access Research article Predictors of mortality in HIV-1 infected children on antiretroviral therapy in Kenya: a prospective cohort 1 1 2,3 4 1 Dalton C Wamalwa* , Elizabeth M Obimbo , Carey Farquhar , Barbra A Richardson , Dorothy A Mbori-Ngacha , 5 2 2,3 Irene Inwani , Sara Benki-Nugent and Grace John-Stewart Abstract Background: Among children, early mortality following highly active antiretroviral therapy (HAART) remains high. It is important to define correlates of mortality in order to improve outcome. Methods: HIV-1-infected children aged 18 months-12 years were followed up at Kenyatta National Hospital, Nairobi after initiating NNRTI-based HAART. Cofactors for mortality were determined using multivariate Cox regression models. Results: Between August 2004 and November 2008, 149 children were initiated on HAART of whom 135 were followed for a total of 238 child-years (median 21 months) after HAART initiation. Baseline median CD4% was 6.8% and median HIV-1-RNA was 5.98-log10 copies/ml. Twenty children (13.4%) died at a median of 35 days post-HAART initiation. Mortality during the entire follow-up period was 8.4 deaths per 100 child-years (46 deaths/100 child-years in first 4 months and 1.0 deaths/100 child-years after 4 months post-HAART initiation). On univariate Cox regression, baseline hemoglobin (Hb) 9 g/dl, weight-for-height z-score (WHZ) -2, and WHO clinical stage 4 were associated with increased risk of death (Hb 9 g/dl HR 3.00 [95% C.I. 1.21-7.39], p = 0.02, WHZ -2 HR 3.41 [95% C.I. 1.28-9.08], p