Survival Benefit of Early Infant Antiretroviral Therapy is Compromised When Diagnosis is Delayed

Late presentation is common among African HIV-1–infected infants. Incidence and correlates of mortality were examined in 99 infants with HIV-1 diagnosis by 5 months of age. Twelve-month survival was 66.8% (95% confidence interval: 55.9–75.6%). World Health Organization stage 3 or 4, underweight, wasting, microcephaly, low hemoglobin, pneumonia and gastroenteritis predicted mortality. Early HIV-1 diagnosis with antiretroviral therapy before symptomatic disease is critical for infant survival.

[1]  M. Egger,et al.  Early Mortality and Loss to Follow-up in HIV-Infected Children Starting Antiretroviral Therapy in Southern Africa , 2010, Journal of acquired immune deficiency syndromes.

[2]  P. Novosad,et al.  Early Clinical Outcomes in Children Enrolled in Human Immunodeficiency Virus Infection Care and Treatment in Lesotho , 2009, The Pediatric infectious disease journal.

[3]  J. Stockman.  Early Antiretroviral Therapy and Mortality among HIV-Infected Infants , 2010 .

[4]  Z. Gizlice,et al.  Mortality and Associated Factors After Initiation of Pediatric Antiretroviral Treatment in the Democratic Republic of the Congo , 2009, The Pediatric infectious disease journal.

[5]  Victor Segalen Bordeaux,et al.  Low Risk of Death, but Substantial Program Attrition, in Pediatric HIV Treatment Cohorts in Sub-Saharan Africa , 2008, Journal of acquired immune deficiency syndromes.

[6]  James A McIntyre,et al.  Early antiretroviral therapy and mortality among HIV-infected infants. , 2008, The New England journal of medicine.

[7]  B. Chi,et al.  Clinical outcomes and CD4 cell response in children receiving antiretroviral therapy at primary health care facilities in Zambia. , 2007, JAMA.

[8]  J. Overbaugh,et al.  Early Response to Highly Active Antiretroviral Therapy in HIV-1-Infected Kenyan Children , 2007, Journal of acquired immune deficiency syndromes.

[9]  B. Eley,et al.  Antiretroviral treatment for children. , 2006, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[10]  J. Overbaugh,et al.  Predictors of Early Mortality in a Cohort of Human Immunodeficiency Virus Type 1-Infected African Children , 2004, The Pediatric infectious disease journal.