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DC Field | Value | Language |
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dc.contributor.author | Ciaranello, Andrea | - |
dc.contributor.author | Lu, Zhigang | - |
dc.contributor.author | Ayaya, Samuel | - |
dc.contributor.author | Losina, Elena | - |
dc.contributor.author | Musick, Beverly | - |
dc.contributor.author | Vreeman, Rachel | - |
dc.contributor.author | Freedberg, Kenneth A. | - |
dc.contributor.author | Abrams, Elaine J. | - |
dc.contributor.author | Dillabaugh, Lisa | - |
dc.contributor.author | Doherty, Katie | - |
dc.contributor.author | Ssali, John | - |
dc.contributor.author | Yiannoutsos, Constantin T. | - |
dc.contributor.author | Wools-Kaloustian, Kara | - |
dc.date.accessioned | 2020-08-04T07:51:23Z | - |
dc.date.available | 2020-08-04T07:51:23Z | - |
dc.date.issued | 2014 | - |
dc.identifier.uri | doi:10.1097/INF.0000000000000223 | - |
dc.identifier.uri | http://ir.mu.ac.ke:8080/jspui/handle/123456789/3293 | - |
dc.description.abstract | Background Few studies have reported CD4%- and age-stratified rates of WHO Stage 3 (WHO3) events, WHO Stage 4 (WHO4) events, tuberculosis (TB), and mortality in HIV-infected infants before initiation of antiretroviral therapy (ART). Methods HIV-infected children enrolled before 1 year of age in the International Epidemiologic Databases to Evaluate AIDS (IeDEA) East Africa region (10/01/2002-11/30/2008) were included. We estimated incidence rates of earliest clinical event (WHO3, WHO4, and TB), prior to ART initiation per local guidelines, stratified by current age (< or ≥6 months) and current CD4% (<15%, 15–24%, ≥25%). CD4%-stratified mortality rates were estimated separately for children who did not experience a clinical event (“background” mortality) and for children who experienced an event, including “acute” mortality (≤30 days post-event) and “later” mortality (>30 days post-event). Results Among 847 children (median enrollment age: 4.8 months; median pre-ART follow-up: 10.8 months; 603 (71%) with ≥1 CD4% recorded), event rates were comparable for those aged <6 and ≥6 months. Current CD4% was associated with risk of WHO4 events for children <6 months old, and with all evaluated events for children ≥6 months old (p<0.05). “Background” mortality was 3.7–8.4/100py. “Acute” mortality (≤30 days post-event) was 33.8/100py (after TB) and 41.1/100py (after WHO3 or WHO4). “Later” mortality (>30 days post-event) ranged by CD4% from 4.7–29.1/100py. Conclusions In treatment-naïve, HIV-infected infants, WHO3, WHO4, and TB events were common before and after 6 months of age and led to substantial increases in mortality. Early infant HIV diagnosis and treatment are critically important, regardless of CD4%. | en_US |
dc.language.iso | en | en_US |
dc.publisher | PMC | en_US |
dc.subject | Pediatric HIV | en_US |
dc.subject | Opportunistic infection | en_US |
dc.subject | Morbidity | en_US |
dc.subject | Mortality | en_US |
dc.title | Incidence of World Health Organization stage 3 and 4 events, tuberculosis and mortality in untreated, HIV-infected children enrolling in care before 1 year of age: an IeDEA (International Epidemiologic Databases To Evaluate AIDS) East Africa Regional Analysis | en_US |
dc.type | Article | en_US |
Appears in Collections: | School of Medicine |
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