Predictors of mortality in HIV-1 infected children on antiretroviral ...
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Predictors of mortality in HIV-1 infected children on antiretroviral ...
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RESEARCH ARTICLE
Open Access
Predictors of mortality in HIV-1 infected children on antiretroviral therapy in Kenya: a prospective cohort Research article
Dalton C Wamalwa*1, Elizabeth M Obimbo1, Carey Farquhar2,3, Barbra A Richardson4, Dorothy A Mbori-Ngacha1, Irene Inwani5, Sara Benki-Nugent2 and Grace John-Stewart2,3
Abstract Background: Among children, early mortality following highly active antiretroviral therapy (HAART) remains high. It is important to define correlates of mortality in order to improve outcome. Methods: HIV-1-infected children aged 18 months-12 years were followed up at Kenyatta National Hospital, Nairobi after initiating NNRTI-based HAART. Cofactors for mortality were determined using multivariate Cox regression models. Results: Between August 2004 and November 2008, 149 children were initiated on HAART of whom 135 were followed for a total of 238 child-years (median 21 months) after HAART initiation. Baseline median CD4% was 6.8% and median HIV-1-RNA was 5.98-log10 copies/ml. Twenty children (13.4%) died at a median of 35 days post-HAART initiation. Mortality during the entire follow-up period was 8.4 deaths per 100 child-years (46 deaths/100 child-years in first 4 months and 1.0 deaths/100 child-years after 4 months post-HAART initiation). On univariate Cox regression, baseline hemoglobin (Hb)
