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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/1120

Title: Predictors of Mortality in a Clinic Cohort of HIV-1 Infected Children Initiated on Antiretroviral Therapy in Jos, Nigeria.
Authors: Ebonyi, Augustine O.
Oguche, Stephen
Meloni, Seema T.
Sagay, Solomon A.
Kyriacou, Demetrious N.
Achenbach, Chad J.
Agbaji, Oche O.
Oyebode, Tinuade A.
Okonkwo, Prosper
Idoko, John A.
Kanki, Phyllis J.
Keywords: Severe immunodeficiency
Issue Date: Dec-2014
Publisher: Journal of AIDS and Clinical Research.
Series/Report no.: Vol. 5;No. 12; Pp 2-7
Abstract: 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<0.001]. On unadjusted Cox regression, the risk of dying was about three and half times more in children <5 years of age compared to those >5 years (p=0.02) Multivariate modeling identified age as the main predictor of death with mortality decreasing by 24% for every 1 year increase in age (Adjusted Hazard Ratio (AHR)=0.76 [0.62-0.94], p=0.013. Conclusion: The lower mortality rate for our study suggests that even in RLC, mortality rates could be reduced given a good standard of care. Early initiation of ART in younger children with close monitoring during follow-up could further reduce mortality.
URI: http://hdl.handle.net/123456789/1120
ISSN: 2155-6113
Appears in Collections:Paediatrics

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