Predictors of survival at three years follow up for HIV-infected children in Cote D'Ivoire

HIV Treatment Bulletin - Vol. 6, No. 9, September 2005

In an oral presentation from the ANRS 1244/1278 study Dr Philippe Msellati of the Institute de Recherché pour le Development, Montpelier, France reported predictors of survival in children enrolled in the study at three years. This observational cohort enrolled children between October 2000 and December 2003 and followed them until the end of September 2004.

The investigators evaluated multiple factors that could influence a child’s survival: whether the parents were alive; age and sex; route of infection; history of TB, malnutrition and of HAART before recruitment and anthropometric measures. Additionally, they analysed hepatitis B, haemoglobin, platelets, number of total lymphocytes, CD4 counts and percentage, and viral load. Probabilities of survival were estimated using the Kaplan-Meier method. Cox proportional hazards regression models were used.

Two hundred and eighty two children were enrolled (129 girls and 153 boys) with a mean age of 5.8 years. The majority of children (98%) had been infected through mother to child transmission. The median baseline CD4% was 14% and the median viral load was 160,000 copies/mL. The average follow up was 2.17 years.

After one year of follow up 85.5% children had survived and 80.9% were still alive at 3 years of follow up.

The investigators reported low weight for age (Z score <-3), history of tuberculosis and viral load >5 log copies/ml had a negative effect on survival (RR: 5.86, 2.37 and 2.04 respectively). They also found that CD4>15% and initiation of HAART before observation or during the first six months of follow up had a protective effect (RR 0.49 and 0.29 respectively). In a model without viral load age over 2 years and CD4>15% were protective (RR: 0.46 and 0.45 respectively).

Ref: Msellati P, Anaky MF, Rouet F et al. Clinical and biological factors at recruitment in HIV-infected children in relation with three years survival in Abidjan, Cote D’Ivoire; the experience of the ANRS 1244/1278 study. IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: (Abstract No. WeOa0101).

050910
IB050609-09

©2005. I-BASE HIV Treatment Bulletin. Permission to reproduce courtesy of HIV i-Base, Third Floor East, Thrale House, 44-46 Southwark Street, London SE1 1UN - T: +44 (0) 20 7407 8488 F: +44 (0) 20 7407 8489

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2005. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2005. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.