Mortality in Children with Human Immunodeficiency Virus Initiating Treatment: A Six-Cohort Study in Latin America
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2017 |
| Outros Autores: | , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da UNIFESP |
| Texto Completo: | http://dx.doi.org/10.1016/j.jpeds.2016.12.034 https://repositorio.unifesp.br/handle/11600/55082 |
Resumo: | Objectives To assess the risks of and factors associated with mortality, loss to follow-up, and changing regimens after children with HIV infected perinatally initiate combination antiretroviral therapy (cART) in Latin America and the Caribbean. Study design This 1997-2013 retrospective cohort study included 1174 antiretroviral therapy-naive, perinatally infected children who started cART age when they were younger than 18 years of age (median 4.7 years |
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Mortality in Children with Human Immunodeficiency Virus Initiating Treatment: A Six-Cohort Study in Latin AmericaObjectives To assess the risks of and factors associated with mortality, loss to follow-up, and changing regimens after children with HIV infected perinatally initiate combination antiretroviral therapy (cART) in Latin America and the Caribbean. Study design This 1997-2013 retrospective cohort study included 1174 antiretroviral therapy-naive, perinatally infected children who started cART age when they were younger than 18 years of age (median 4.7 yearsIQR 1.7-8.8) at 1 of 6 cohorts from Argentina, Brazil, Haiti, and Honduras, within the Caribbean, Central and South America Network for HIV Epidemiology. Median follow-up was 5.6 years (IQR 2.3-9.3). Study outcomes were all-cause mortality, loss to follow-up, and major changes in cART. We used Cox proportional hazards models stratified by site to examine the association between predictors and times to death or changing regimens. Results Only 52% started cART at younger than 5 years of age19% began a protease inhibitor. At cART initiation, median CD4 count was 472 cells/mm3 (IQR 201-902)median CD4% was 16% (IQR 10-23). Probability of death was high in the first year of cART: 0.06 (95% CI 0.04-0.07). Five years after cART initiation, the cumulative mortality incidence was 0.12 (95% CI 0.10-0.14). Cumulative incidences for loss to follow-up and regimen change after 5 years were 0.16 (95% 0.14-0.18) and 0.30 (95% 0.26-0.34), respectively. Younger children had the greatest risk of mortality, whereas older children had the greatest risk of being lost to follow-up or changing regimens. Conclusions Innovative clinical and community approaches are needed for quality improvement in the pediatric care of HIV in the Americas.Social Secur Honduran Inst, Dept Pediat, Tegucigalpa, HondurasVanderbilt Univ, Sch Med, Dept Biostat, Nashville, TN 37212 USAVanderbilt Univ, Sch Med, Dept Med, Nashville, TN 37212 USAVanderbilt Univ, Sch Med, Dept Pediat, Nashville, TN 37212 USAVanderbilt Inst Global Hlth, Nashville, TN USAHaitian Grp Studies Kaposi Sarcoma & Opportunist, Port Au Prince, HaitiUniv Fed Sao Paulo, Sch Med, Dept Pediat, Sao Paulo, BrazilUniv Fed Minas Gerais, Sch Med, Dept Pediat, Belo Horizonte, MG, BrazilUniv Fed Sao Paulo, Sch Med, Dept Pediat, Sao Paulo, BrazilWeb of ScienceNational Institute of Allergy and Infectious DiseasesEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNational Cancer Institute through Vanderbilt University School of MedicineNational Cancer Institute through Vanderbilt University School of Medicine: U01 AI069923Mosby-Elsevier2020-07-17T14:02:54Z2020-07-17T14:02:54Z2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion245-252http://dx.doi.org/10.1016/j.jpeds.2016.12.034Journal Of Pediatrics. New York, v. 182, p. 245-252, 2017.10.1016/j.jpeds.2016.12.0340022-3476https://repositorio.unifesp.br/handle/11600/55082WOS:000396252400040engJournal Of PediatricsNew Yorkinfo:eu-repo/semantics/openAccessLuque, Marco T.Jenkins, Cathy A.Shepherd, Bryan E.Padgett, DenisRouzier, VanessaSucci, Regina Celia M. [UNIFESP]Machado, Daisy M. [UNIFESP]McGowan, Catherine C.Vermund, Sten H.Pinto, Jorge A.reponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2022-02-07T21:05:57Zoai:repositorio.unifesp.br/:11600/55082Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652022-02-07T21:05:57Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
| dc.title.none.fl_str_mv |
Mortality in Children with Human Immunodeficiency Virus Initiating Treatment: A Six-Cohort Study in Latin America |
| title |
Mortality in Children with Human Immunodeficiency Virus Initiating Treatment: A Six-Cohort Study in Latin America |
| spellingShingle |
Mortality in Children with Human Immunodeficiency Virus Initiating Treatment: A Six-Cohort Study in Latin America Luque, Marco T. |
| title_short |
Mortality in Children with Human Immunodeficiency Virus Initiating Treatment: A Six-Cohort Study in Latin America |
| title_full |
Mortality in Children with Human Immunodeficiency Virus Initiating Treatment: A Six-Cohort Study in Latin America |
| title_fullStr |
Mortality in Children with Human Immunodeficiency Virus Initiating Treatment: A Six-Cohort Study in Latin America |
| title_full_unstemmed |
Mortality in Children with Human Immunodeficiency Virus Initiating Treatment: A Six-Cohort Study in Latin America |
| title_sort |
Mortality in Children with Human Immunodeficiency Virus Initiating Treatment: A Six-Cohort Study in Latin America |
| author |
Luque, Marco T. |
| author_facet |
Luque, Marco T. Jenkins, Cathy A. Shepherd, Bryan E. Padgett, Denis Rouzier, Vanessa Succi, Regina Celia M. [UNIFESP] Machado, Daisy M. [UNIFESP] McGowan, Catherine C. Vermund, Sten H. Pinto, Jorge A. |
| author_role |
author |
| author2 |
Jenkins, Cathy A. Shepherd, Bryan E. Padgett, Denis Rouzier, Vanessa Succi, Regina Celia M. [UNIFESP] Machado, Daisy M. [UNIFESP] McGowan, Catherine C. Vermund, Sten H. Pinto, Jorge A. |
| author2_role |
author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Luque, Marco T. Jenkins, Cathy A. Shepherd, Bryan E. Padgett, Denis Rouzier, Vanessa Succi, Regina Celia M. [UNIFESP] Machado, Daisy M. [UNIFESP] McGowan, Catherine C. Vermund, Sten H. Pinto, Jorge A. |
| description |
Objectives To assess the risks of and factors associated with mortality, loss to follow-up, and changing regimens after children with HIV infected perinatally initiate combination antiretroviral therapy (cART) in Latin America and the Caribbean. Study design This 1997-2013 retrospective cohort study included 1174 antiretroviral therapy-naive, perinatally infected children who started cART age when they were younger than 18 years of age (median 4.7 years |
| publishDate |
2017 |
| dc.date.none.fl_str_mv |
2017 2020-07-17T14:02:54Z 2020-07-17T14:02:54Z |
| dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
| dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1016/j.jpeds.2016.12.034 Journal Of Pediatrics. New York, v. 182, p. 245-252, 2017. 10.1016/j.jpeds.2016.12.034 0022-3476 https://repositorio.unifesp.br/handle/11600/55082 WOS:000396252400040 |
| url |
http://dx.doi.org/10.1016/j.jpeds.2016.12.034 https://repositorio.unifesp.br/handle/11600/55082 |
| identifier_str_mv |
Journal Of Pediatrics. New York, v. 182, p. 245-252, 2017. 10.1016/j.jpeds.2016.12.034 0022-3476 WOS:000396252400040 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
| dc.relation.none.fl_str_mv |
Journal Of Pediatrics |
| dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
| eu_rights_str_mv |
openAccess |
| dc.format.none.fl_str_mv |
245-252 |
| dc.coverage.none.fl_str_mv |
New York |
| dc.publisher.none.fl_str_mv |
Mosby-Elsevier |
| publisher.none.fl_str_mv |
Mosby-Elsevier |
| dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
| instname_str |
Universidade Federal de São Paulo (UNIFESP) |
| instacron_str |
UNIFESP |
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UNIFESP |
| reponame_str |
Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
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biblioteca.csp@unifesp.br |
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1814268451172122624 |