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Outcomes of human immunodeficiency virus‐infected children after anti‐retroviral therapy in M alaysia
Author(s) -
Moy Fong Siew,
Fahey Paul,
Nik Yusoff Nik K,
Razali Kamarul A,
Nallusamy Revathy
Publication year - 2015
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12712
Subject(s) - medicine , interquartile range , wasting , mortality rate , antiretroviral therapy , pediatrics , cohort , retrospective cohort study , human immunodeficiency virus (hiv) , viral load , immunology
Aims To describe outcome and examine factors associated with mortality among human immunodeficiency virus ( HIV )‐infected children in M alaysia after anti‐retroviral therapy ( ART ). Methods Retrospective and prospective data collected through M arch 2009 from children in four different states in M alaysia enrolled in TREAT Asia's P ediatric HIV O bservational D atabase were analysed. Results Of 347 children in the cohort, only 278 (80.1%) were commenced on ART . The median CD 4 count and median age at baseline prior to ART was 272 cells/μL and 4.2 years (interquartile range (IQR): 1.4, 7.4 years), respectively. The median duration of follow‐up was 3.7 years (IQR: 1.8, 6.0) with 32 deaths giving a crude mortality rate of 2.86 per 100 child‐years. The mortality rate highest in the first 6 months of ART was 10.62 per 100 child‐years and declined to 1.83 per 100 child‐years thereafter. On u nivariate analyses, only baseline median CD 4 percentage, weight for age z score, height for age z score and anaemia were significantly associated with mortality. Upon including all four of these predictors into a single multivariate model, only weight for age z score remained statistically significantly predictive of mortality. Conclusions Children commenced on ART had high mortality in the first 6 months especially in those with low CD 4 percentage, wasting and anaemia. Poor nutritional status is an important independent predictor of mortality in this study. Besides initiating ART therapy, nutritional support and intervention must receive the utmost attention.