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Early neurodevelopmental markers predictive of mortality in infants infected with HIV‐1
Author(s) -
Llorente Antolin,
Brouwers Pim,
Charurat Manhattan,
Malee Kathleen,
Mellins Claude,
Ware Janice,
Hittleman Joan,
Mofenson Lynne,
VelezBorras Jesus,
AdeniyiJones Samuel
Publication year - 2003
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2003.tb00909.x
Subject(s) - bayley scales of infant development , medicine , gestational age , pediatrics , quartile , hazard ratio , proportional hazards model , confounding , survival analysis , psychomotor learning , pregnancy , confidence interval , biology , psychiatry , genetics , cognition
One‐hundred and fifty‐seven vertically infected HIV‐1 positive infants (85 males, 72 females) underwent longitudinal assessment to determine whether early neurodevelopmental markers are useful predictors of mortality in those infants who survive to at least 4 months of age. Survival analysis methods were used to estimate time to death for quartiles of 4‐month scores (baseline) on the Bayley Scales of Infant Development (BSID). Cox proportional hazards progression was used to estimate relative hazard (RH, 95% CI) of death for BSID scores and potential confounders. Thirty infants with BSID scores at 4 months of age died during follow‐up. Survival analysis revealed greater mortality rates in infants with BSID (Mental Developmental Index and Psychomotor Developmental Index) scores in the lower quartile( p =0.004, p =0.036). Unadjusted univariate analyses revealed increased mortality associated with baseline CD4 + 29%, gestational age <37 weeks, smaller head circumference, advanced HIV and higher plasma viral load. BSID scores independently predicted mortality after adjusting for treatment, clinical category, gestational age, plasma viral load and CD4 + percentage.