دورية أكاديمية
أعرض في EDS

Immunodeficiency in children starting antiretroviral therapy in low-, middle-, and high-income countries.

التفاصيل البيبلوغرافية
العنوان: Immunodeficiency in children starting antiretroviral therapy in low-, middle-, and high-income countries.
المؤلفون: Koller M; Institute of Social & Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; †Department of Epidemiology, Harvard School of Public Health, Boston, MA; ‡Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; §Department of Medicine, Indiana University School of Medicine, Indianapolis, IN; ‖Department of Pediatrics, Gabriel Toure Hospital, Bamako, Mali; ¶Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; #Newlands Clinic, Harare, Zimbabwe; **Maternal and Pediatric Infectious Disease Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD; ††Department of Pediatrics, College of Health Sciences, Moi University, Kenya; ‡‡INSERM, French National Institute for Health and Medical Research, U897, Bordeaux, France; §§Children's Hospital 1, Ho Chi Minh City, Vietnam; and ‖‖School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa., Patel K, Chi BH, Wools-Kaloustian K, Dicko F, Chokephaibulkit K, Chimbetete C, Avila D, Hazra R, Ayaya S, Leroy V, Truong HK, Egger M, Davies MA
مؤلفون مشاركون: IeDEA, NISDI, PHACS and IMPAACT 219C studies
المصدر: Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2015 Jan 01; Vol. 68 (1), pp. 62-72.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins, Inc Country of Publication: United States NLM ID: 100892005 Publication Model: Print Cited Medium: Internet ISSN: 1944-7884 (Electronic) Linking ISSN: 15254135 NLM ISO Abbreviation: J Acquir Immune Defic Syndr Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, Inc., c1999-
مواضيع طبية MeSH: Anti-HIV Agents/*therapeutic use, Anti-HIV Agents/immunology ; CD4 Lymphocyte Count ; Child ; Developed Countries ; Developing Countries ; Humans
مستخلص: Background: The CD4 cell count or percent (CD4%) at the start of combination antiretroviral therapy (cART) is an important prognostic factor in children starting therapy and an important indicator of program performance. We describe trends and determinants of CD4 measures at cART initiation in children from low-, middle-, and high-income countries.
Methods: We included children aged <16 years from clinics participating in a collaborative study spanning sub-Saharan Africa, Asia, Latin America, and the United States. Missing CD4 values at cART start were estimated through multiple imputation. Severe immunodeficiency was defined according to World Health Organization criteria. Analyses used generalized additive mixed models adjusted for age, country, and calendar year.
Results: A total of 34,706 children from 9 low-income, 6 lower middle-income, 4 upper middle-income countries, and 1 high-income country (United States) were included; 20,624 children (59%) had severe immunodeficiency. In low-income countries, the estimated prevalence of children starting cART with severe immunodeficiency declined from 76% in 2004 to 63% in 2010. Corresponding figures for lower middle-income countries were from 77% to 66% and for upper middle-income countries from 75% to 58%. In the United States, the percentage decreased from 42% to 19% during the period 1996 to 2006. In low- and middle-income countries, infants and children aged 12-15 years had the highest prevalence of severe immunodeficiency at cART initiation.
Conclusions: Despite progress in most low- and middle-income countries, many children continue to start cART with severe immunodeficiency. Early diagnosis and treatment of HIV-infected children to prevent morbidity and mortality associated with immunodeficiency must remain a global public health priority.
التعليقات: Comment in: J Acquir Immune Defic Syndr. 2015 Oct 1;70(2):e70-1. (PMID: 25886929)
Comment in: J Acquir Immune Defic Syndr. 2015 Oct 1;70(2):e71-2. (PMID: 26218412)
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معلومات مُعتمدة: U01 HD052104 United States HD NICHD NIH HHS; 5U01-AI069924-05 United States AI NIAID NIH HHS; N01 HD033345 United States HD NICHD NIH HHS; N01-HD-8-0001 United States HD NICHD NIH HHS; HHSN267200800001G United States DK NIDDK NIH HHS; HD052102 United States HD NICHD NIH HHS; N01-HD-3-3345 United States HD NICHD NIH HHS; 5U01AI069919-04 United States AI NIAID NIH HHS; U01 AI068632 United States AI NIAID NIH HHS; 3 U01 HD052102-06S3 United States HD NICHD NIH HHS; U01 AI069927 United States AI NIAID NIH HHS; UM1 AI068632 United States AI NIAID NIH HHS; N01-3-3345 United States PHS HHS; U01AI069911-01 United States AI NIAID NIH HHS; N01HD33345 United States HD NICHD NIH HHS; U01AI069907 United States AI NIAID NIH HHS; 3U01HD052104-06S1 United States HD NICHD NIH HHS; U01 AI068616 United States AI NIAID NIH HHS; 1U01 AI069927 United States AI NIAID NIH HHS; HHSN267200800001C United States HD NICHD NIH HHS; U01 AI041110 United States AI NIAID NIH HHS; U01 AI069911 United States AI NIAID NIH HHS; UM1 AI068616 United States AI NIAID NIH HHS; U01 AI069919 United States AI NIAID NIH HHS; U01 AI069907 United States AI NIAID NIH HHS; U01 HD052102 United States HD NICHD NIH HHS; HHSN267200800001C United States PHS HHS; UL1 TR001082 United States TR NCATS NIH HHS; 3 U01 HD052102-05S1 United States HD NICHD NIH HHS; 1 U01 AI068616 United States AI NIAID NIH HHS; 5 U01 AI41110 United States AI NIAID NIH HHS; HD052104 United States HD NICHD NIH HHS; U01 AI069924 United States AI NIAID NIH HHS
المشرفين على المادة: 0 (Anti-HIV Agents)
تواريخ الأحداث: Date Created: 20141216 Date Completed: 20150224 Latest Revision: 20200930
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC4351302
DOI: 10.1097/QAI.0000000000000380
PMID: 25501345
قاعدة البيانات: MEDLINE
الوصف
تدمد:1944-7884
DOI:10.1097/QAI.0000000000000380