Mortality and loss to follow up before initiation of antiretroviral therapy among HIV-infected children eligible for HIV treatment
Data on attrition due to mortality or loss to follow-up (LTFU) from antiretroviral therapy (ART) eligibility to ART initiation of HIV-infected children are scarce. The aim of this study is to describe attrition before ART initiation of 247 children who were eligible for ART in a cohort study in Indi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2014-05-01
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| Series: | Infectious Disease Reports |
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| Online Access: | http://www.pagepress.org/journals/index.php/idr/article/view/5167 |
| _version_ | 1828939862556803072 |
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| author | Gerardo Alvarez-Uria Praveen Kumar Naik Manoranjan Midde Raghavakalyan Pakam |
| author_facet | Gerardo Alvarez-Uria Praveen Kumar Naik Manoranjan Midde Raghavakalyan Pakam |
| author_sort | Gerardo Alvarez-Uria |
| collection | DOAJ |
| description | Data on attrition due to mortality or loss to follow-up (LTFU) from antiretroviral therapy (ART) eligibility to ART initiation of HIV-infected children are scarce. The aim of this study is to describe attrition before ART initiation of 247 children who were eligible for ART in a cohort study in India. Multivariable analysis was performed using competing risk regression. The cumulative incidence of attrition was 12.6% (95% confidence interval, 8.7-17.3) after five years of follow-up, and the attrition rate was higher during the first months after ART eligibility. Older children (>9 years) had a lower mortality risk before ART initiation than those aged <2 years. Female children had a lower risk of LTFU before ART initiation than males. Children who belonged to scheduled tribes had a higher risk of delayed ART initiation and LTFU. Orphan children had a higher risk of delayed ART initiation and mortality. Children who were >3 months in care before ART eligibility were less likely to be LTFU. The 12-month risk of AIDS, which was calculated using the absolute CD4 cell count and age, was strongly associated with mortality. A substantial proportion of ART-eligible children died or were LTFU before the initiation of ART. These findings can be used in HIV programmes to design actions aimed at reducing the attrition of ART-eligible children in India. |
| first_indexed | 2024-12-14T03:09:16Z |
| format | Article |
| id | doaj.art-c4bd90e5c8ff493eb212b9045515855d |
| institution | Directory Open Access Journal |
| issn | 2036-7430 2036-7449 |
| language | English |
| last_indexed | 2024-12-14T03:09:16Z |
| publishDate | 2014-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Infectious Disease Reports |
| spelling | doaj.art-c4bd90e5c8ff493eb212b9045515855d2022-12-21T23:19:19ZengMDPI AGInfectious Disease Reports2036-74302036-74492014-05-016210.4081/idr.2014.51672805Mortality and loss to follow up before initiation of antiretroviral therapy among HIV-infected children eligible for HIV treatmentGerardo Alvarez-Uria0Praveen Kumar Naik1Manoranjan Midde2Raghavakalyan Pakam3Department of Infectious Diseases, Rural Development Trust Hospital, Bathalapalli, APDepartment of Infectious Diseases, Rural Development Trust Hospital, Bathalapalli, APDepartment of Infectious Diseases, Rural Development Trust Hospital, Bathalapalli, APDepartment of Infectious Diseases, Rural Development Trust Hospital, Bathalapalli, APData on attrition due to mortality or loss to follow-up (LTFU) from antiretroviral therapy (ART) eligibility to ART initiation of HIV-infected children are scarce. The aim of this study is to describe attrition before ART initiation of 247 children who were eligible for ART in a cohort study in India. Multivariable analysis was performed using competing risk regression. The cumulative incidence of attrition was 12.6% (95% confidence interval, 8.7-17.3) after five years of follow-up, and the attrition rate was higher during the first months after ART eligibility. Older children (>9 years) had a lower mortality risk before ART initiation than those aged <2 years. Female children had a lower risk of LTFU before ART initiation than males. Children who belonged to scheduled tribes had a higher risk of delayed ART initiation and LTFU. Orphan children had a higher risk of delayed ART initiation and mortality. Children who were >3 months in care before ART eligibility were less likely to be LTFU. The 12-month risk of AIDS, which was calculated using the absolute CD4 cell count and age, was strongly associated with mortality. A substantial proportion of ART-eligible children died or were LTFU before the initiation of ART. These findings can be used in HIV programmes to design actions aimed at reducing the attrition of ART-eligible children in India.http://www.pagepress.org/journals/index.php/idr/article/view/5167India, HIV, lost to follow-up, antiretroviral therapy, elegibility determination |
| spellingShingle | Gerardo Alvarez-Uria Praveen Kumar Naik Manoranjan Midde Raghavakalyan Pakam Mortality and loss to follow up before initiation of antiretroviral therapy among HIV-infected children eligible for HIV treatment Infectious Disease Reports India, HIV, lost to follow-up, antiretroviral therapy, elegibility determination |
| title | Mortality and loss to follow up before initiation of antiretroviral therapy among HIV-infected children eligible for HIV treatment |
| title_full | Mortality and loss to follow up before initiation of antiretroviral therapy among HIV-infected children eligible for HIV treatment |
| title_fullStr | Mortality and loss to follow up before initiation of antiretroviral therapy among HIV-infected children eligible for HIV treatment |
| title_full_unstemmed | Mortality and loss to follow up before initiation of antiretroviral therapy among HIV-infected children eligible for HIV treatment |
| title_short | Mortality and loss to follow up before initiation of antiretroviral therapy among HIV-infected children eligible for HIV treatment |
| title_sort | mortality and loss to follow up before initiation of antiretroviral therapy among hiv infected children eligible for hiv treatment |
| topic | India, HIV, lost to follow-up, antiretroviral therapy, elegibility determination |
| url | http://www.pagepress.org/journals/index.php/idr/article/view/5167 |
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