Bihui Yang, Mi Zhang, Y. Shu, Jia-fa Liu, Jian-jian Li, Cuixian Yang, Jincheng Lou
{"title":"云南省接受高效抗逆转录病毒治疗的人类免疫缺陷病毒感染儿童死亡率的风险和预测因素","authors":"Bihui Yang, Mi Zhang, Y. Shu, Jia-fa Liu, Jian-jian Li, Cuixian Yang, Jincheng Lou","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.01.005","DOIUrl":null,"url":null,"abstract":"Objective \nTo investigate the influence factors of mortality among human immunodeficiency virus (HIV)-infected children under highly active antiretroviral therapy (HAART). \n \n \nMethods \nRetrospective cohort study of 652 children initiated HAART from 2005 to 2014 was conducted, and enrolled patients were followed-up until December, 2015. Survival data was analyzed using Kaplan-Meier method and Cox regression model was used to identify independent predictors of mortality among these children on HARRT. Chi-square test and Fisher′s exact test were used for comparison between groups. \n \n \nResults \nOverall, 26 of the children died over a follow-up period of 3 116.24 child-years, with a mortality rate of 0.83 per 100 child-years. Twelve (46%) of deaths occurred during the first six months after starting HAART. Cox regression analysis of variables showed that the World Health Organization (WHO) clinical stages Ⅲ/Ⅳ (hazard rate [HR]=10.717, 95% confidence interal [95% CI]: 4.189-4.749, P=0.000), baseline hemoglobin <80 g/L (HR=14.768, 95% CI: 5.721-38.125, P=0.000), tuberculosis co-infection (HR=4.794, 95%CI: 2.105-10.918, P=0.000), baseline CD4+ T lymphocyte<50 cells/μL (HR=4.219, 95%CI: 1.524-11.680, P=0.006), weight-for-age z-score <-2 (HR=2.983, 95%CI: 1.094-8.135, P=0.033)were independently associated with death, whereas the age <7 year-old at HAART initiation was protectire (HR=0.293, 95% CI: 0.126-0.684, P=0.005). \n \n \nConclusions \nThe mortality of children receiving HAART is strongly associated with WHO stages Ⅲ/Ⅳ, hemoglobin <80 g/L, weight-for-age z-score <-2, tuberculosis co-infection and older age at treatment. \n \n \nKey words: \nChild; Acquired immunodeficiency syndrome; Antiretroviral treatment","PeriodicalId":10127,"journal":{"name":"中华传染病杂志","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risks and predictors of mortality among human immunodeficiency virus-infected children receiving highly active antiretroviral therapy in Yunnan Province\",\"authors\":\"Bihui Yang, Mi Zhang, Y. Shu, Jia-fa Liu, Jian-jian Li, Cuixian Yang, Jincheng Lou\",\"doi\":\"10.3760/CMA.J.ISSN.1000-6680.2019.01.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective \\nTo investigate the influence factors of mortality among human immunodeficiency virus (HIV)-infected children under highly active antiretroviral therapy (HAART). \\n \\n \\nMethods \\nRetrospective cohort study of 652 children initiated HAART from 2005 to 2014 was conducted, and enrolled patients were followed-up until December, 2015. Survival data was analyzed using Kaplan-Meier method and Cox regression model was used to identify independent predictors of mortality among these children on HARRT. Chi-square test and Fisher′s exact test were used for comparison between groups. \\n \\n \\nResults \\nOverall, 26 of the children died over a follow-up period of 3 116.24 child-years, with a mortality rate of 0.83 per 100 child-years. Twelve (46%) of deaths occurred during the first six months after starting HAART. Cox regression analysis of variables showed that the World Health Organization (WHO) clinical stages Ⅲ/Ⅳ (hazard rate [HR]=10.717, 95% confidence interal [95% CI]: 4.189-4.749, P=0.000), baseline hemoglobin <80 g/L (HR=14.768, 95% CI: 5.721-38.125, P=0.000), tuberculosis co-infection (HR=4.794, 95%CI: 2.105-10.918, P=0.000), baseline CD4+ T lymphocyte<50 cells/μL (HR=4.219, 95%CI: 1.524-11.680, P=0.006), weight-for-age z-score <-2 (HR=2.983, 95%CI: 1.094-8.135, P=0.033)were independently associated with death, whereas the age <7 year-old at HAART initiation was protectire (HR=0.293, 95% CI: 0.126-0.684, P=0.005). \\n \\n \\nConclusions \\nThe mortality of children receiving HAART is strongly associated with WHO stages Ⅲ/Ⅳ, hemoglobin <80 g/L, weight-for-age z-score <-2, tuberculosis co-infection and older age at treatment. \\n \\n \\nKey words: \\nChild; Acquired immunodeficiency syndrome; Antiretroviral treatment\",\"PeriodicalId\":10127,\"journal\":{\"name\":\"中华传染病杂志\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-01-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华传染病杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.01.005\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华传染病杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.01.005","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Risks and predictors of mortality among human immunodeficiency virus-infected children receiving highly active antiretroviral therapy in Yunnan Province
Objective
To investigate the influence factors of mortality among human immunodeficiency virus (HIV)-infected children under highly active antiretroviral therapy (HAART).
Methods
Retrospective cohort study of 652 children initiated HAART from 2005 to 2014 was conducted, and enrolled patients were followed-up until December, 2015. Survival data was analyzed using Kaplan-Meier method and Cox regression model was used to identify independent predictors of mortality among these children on HARRT. Chi-square test and Fisher′s exact test were used for comparison between groups.
Results
Overall, 26 of the children died over a follow-up period of 3 116.24 child-years, with a mortality rate of 0.83 per 100 child-years. Twelve (46%) of deaths occurred during the first six months after starting HAART. Cox regression analysis of variables showed that the World Health Organization (WHO) clinical stages Ⅲ/Ⅳ (hazard rate [HR]=10.717, 95% confidence interal [95% CI]: 4.189-4.749, P=0.000), baseline hemoglobin <80 g/L (HR=14.768, 95% CI: 5.721-38.125, P=0.000), tuberculosis co-infection (HR=4.794, 95%CI: 2.105-10.918, P=0.000), baseline CD4+ T lymphocyte<50 cells/μL (HR=4.219, 95%CI: 1.524-11.680, P=0.006), weight-for-age z-score <-2 (HR=2.983, 95%CI: 1.094-8.135, P=0.033)were independently associated with death, whereas the age <7 year-old at HAART initiation was protectire (HR=0.293, 95% CI: 0.126-0.684, P=0.005).
Conclusions
The mortality of children receiving HAART is strongly associated with WHO stages Ⅲ/Ⅳ, hemoglobin <80 g/L, weight-for-age z-score <-2, tuberculosis co-infection and older age at treatment.
Key words:
Child; Acquired immunodeficiency syndrome; Antiretroviral treatment