دورية أكاديمية
Early Initiation of Antiretroviral Therapy is Protective Against Seizures in Children With HIV in Zambia: A Prospective Case-Control Study.
| العنوان: | Early Initiation of Antiretroviral Therapy is Protective Against Seizures in Children With HIV in Zambia: A Prospective Case-Control Study. |
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| المؤلفون: | Bearden DR; Department of Neurology, University of Rochester, Rochester, NY.; University of Zambia School of Medicine, Lusaka, Zambia.; Department of Educational Psychology, University of Zambia, Lusaka, Zambia., Mwanza-Kabaghe S; Department of Educational Psychology, University of Zambia, Lusaka, Zambia., Bositis CM; Greater Lawrence Family Health Center, Lawrence, MA., Dallah I; University of Rochester, Center for Health and Technology, Rochester, NY., Johnson BA; Department of Biostatistics, University of Rochester, Rochester, NY., Siddiqi OK; Department of Neurology, Beth Israel Deaconess Medical Center, Global Neurology Program, Boston, MA.; University of Zambia, University Teaching Hospitals, Lusaka, Zambia., Elafros MA; Department of Neurology, University of Michigan, Ann Arbor, MI., Gelbard HA; Department of Neurology, University of Rochester, Rochester, NY., Okulicz JF; San Antonio Military Medical Center, Infectious Diseases Service, HIV Medical Evaluation Unit, San Antonio, TX., Kalungwana L; Department of Psychology, University of Zambia, Lusaka, Zambia., Musonda N; Department of Neurology, University of Rochester, Rochester, NY.; University of Rochester, Center for Health and Technology, Rochester, NY., Theodore WH; Epilepsy Division, US National Institute of Health, Bethesda, MD; and., Mwenechanya M; University of Zambia, University Teaching Hospitals, Lusaka, Zambia., Mathews M; University of Zambia, University Teaching Hospitals, Lusaka, Zambia., Sikazwe IT; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia., Birbeck GL; Department of Neurology, University of Rochester, Rochester, NY.; University of Zambia School of Medicine, Lusaka, Zambia.; University of Rochester, Center for Health and Technology, Rochester, NY.; University of Zambia, University Teaching Hospitals, Lusaka, Zambia. |
| المصدر: | Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2024 Mar 01; Vol. 95 (3), pp. 291-296. |
| 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: | HIV Infections*/complications , HIV Infections*/drug therapy , Anti-HIV Agents*/therapeutic use, Child ; Humans ; Infant ; Zambia/epidemiology ; Case-Control Studies ; Risk Factors ; Seizures/drug therapy ; Seizures/prevention & control ; Seizures/complications ; CD4 Lymphocyte Count |
| مستخلص: | Background: Seizures are relatively common among children with HIV in low- and middle-income countries and are associated with significant morbidity and mortality. Early treatment with antiretroviral therapy (ART) may reduce this risk by decreasing rates of central nervous system infections and HIV encephalopathy. Methods: We conducted a prospective, unmatched case-control study. We enrolled children with new-onset seizure from University Teaching Hospital in Lusaka, Zambia and 2 regional hospitals in rural Zambia. Controls were children with HIV and no history of seizures. Recruitment took place from 2016 to 2019. Early treatment was defined as initiation of ART before 12 months of age, at a CD4 percentage >15% in children aged 12-60 months or a CD4 count >350 cells/mm 3 for children aged 60 months or older. Logistic regression models were used to evaluate the association between potential risk factors and seizures. Results: We identified 73 children with new-onset seizure and compared them with 254 control children with HIV but no seizures. Early treatment with ART was associated with a significant reduction in the odds of seizures [odds ratio (OR) 0.04, 95% confidence interval: 0.02 to 0.09; P < 0.001]. Having an undetectable viral load at the time of enrollment was strongly protective against seizures (OR 0.03, P < 0.001), whereas history of World Health Organization Stage 4 disease (OR 2.2, P = 0.05) or CD4 count <200 cells/mm 3 (OR 3.6, P < 0.001) increased risk of seizures. Conclusions: Early initiation of ART and successful viral suppression would likely reduce much of the excess seizure burden in children with HIV. Competing Interests: The authors have no funding or conflicts of interest to disclose. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
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| معلومات مُعتمدة: | K23 NS117310 United States NS NINDS NIH HHS; P30 AI045008 United States AI NIAID NIH HHS; R01 NS094037 United States NS NINDS NIH HHS; R35 NS122265 United States NS NINDS NIH HHS |
| المشرفين على المادة: | 0 (Anti-HIV Agents) |
| تواريخ الأحداث: | Date Created: 20231130 Date Completed: 20240228 Latest Revision: 20240310 |
| رمز التحديث: | 20240310 |
| مُعرف محوري في PubMed: | PMC10922319 |
| DOI: | 10.1097/QAI.0000000000003357 |
| PMID: | 38032746 |
| قاعدة البيانات: | MEDLINE |
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