@article{fdi:010072704,
  title = {{AIDS}-defining events and deaths in {HIV}-infected children and adolescents on antiretrovirals : a 14-year study in {T}hailand},
  author = {{T}raisathit, {P}. and {D}elory, {T}. and {N}go-{G}iang-{H}uong, {N}icole and {S}omsamai, {R}. and {T}echakunakorn, {P}. and {T}heansavettrakul, {S}. and {K}anjanavanit, {S}. and {M}ekmullica, {J}. and {N}gampiyaskul, {C}. and {N}a-{R}ajsima, {S}. and {L}allemant, {M}arc and {C}ressey, {T}. {R}. and {J}ourdain, {G}onzague and {C}ollins, {I}. {J}. and {L}e {C}oeur, {S}ophie},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {D}ata are scarce on the long-term clinical outcomes of perinatally {HIV}-infected children and adolescents receiving antiretroviral therapy ({ART}) in low/middle-income countries. {W}e assessed the incidence of mortality before (early) and after (late) 6 months of {ART} and of the composite outcome of new/recurrent {AIDS}-defining event or death >6 months after {ART} start (late {AIDS}/death) and their associated factors. {M}ethods: {S}tudy population was perinatally {HIV}-infected children (<= 18 years) initiating {ART} within the {P}rogram for {HIV} {P}revention and {T}reatment observational cohort ({NCT}00433030). {F}actors associated with late {AIDS}/death were assessed using competing risk regression models accounting for lost to-follow-up and included baseline and time-updated variables. {R}esults: {A}mong 619 children, "early" mortality incidence was 99 deaths per 1000 person-years of follow-up [95% confidence interval ({CI}): 69 to 142] and "late" mortality 6 per 1000 person-years of follow-up (95% {CI}: 4 to 9). {O}f the 553 children alive >6 months after {ART} initiation, median age at {ART} initiation was 6.4 years, {CD}4% 8.2%, and {HIV}-{RNA} load 5.1 log(10) copies/m{L}. {T}hirty-eight (7%) children developed late {AIDS}/death after median time of 3.3 years: 24 died and 24 experienced new/recurrent {AIDS}-defining events (10 subsequently died). {F}actors independently associated with late {AIDS}/death were current age >= 13 years (adjusted subdistribution hazard ratio 4.9; 95% {CI}: 2.4 to 10.1), {HIV}-{RNA} load always >= 400 copies/m{L} (12.3; 95% {CI}: 4.0 to 37.6), {BMI}-z-score always <-22 {SD} (13.7; 95% {CI}: 3.4 to 55.7), and hemoglobin <8 g/d{L} at least once (4.6; 95% {CI}: 2.0 to 10.5). {C}onclusions: {A}fter the initial 6 months of {ART}, being an adolescent, persistent viremia, poor nutritional status, and severe anemia were associated with poor clinical outcomes. {T}his supports the need for novel interventions that target children, particularly adolescents with poor growth and uncontrolled viremia.},
  keywords = {mortality ; {AIDS} ; {HIV} ; {T}hailand ; children ; adolescents ; {THAILANDE}},
  booktitle = {},
  journal = {{J}aids.{J}ournal of {A}cquired {I}mmune {D}eficiency {S}yndromes},
  volume = {77},
  numero = {1},
  pages = {17--22},
  ISSN = {1525-4135},
  year = {2018},
  URL = {https://www.documentation.ird.fr/hor/fdi:010072704},
}