Author, as appears in the article.: Schomaker M., Leroy V., Wolfs T., Technau K., Renner L., Judd A., Sawry S., Amorissani-Folquet M., Noguera-Julian A., Tanser F., Eboua F., Navarro M., Chimbetete C., Amani-Bosse C., Warszawski J., Phiri S., N'Gbeche S., Cox V., Koueta F., Giddy J., Sygnaté-Sy H., Raben D., Chêne G., Davies M.

Department: Medicina i Cirurgia

URV's Author/s: Vidal Marsal, Francisco

Keywords: Paediatrics G-formula Causal inference Antiretroviral treatment g-formula causal inference antiretroviral treatment

Abstract: BACKGROUND: There is limited knowledge about the optimal timing of antiretroviral treatment initiation in older children and adolescents. METHODS: A total of 20 576 antiretroviral treatment (ART)-naïve patients, aged 1-16 years at enrolment, from 19 cohorts in Europe, Southern Africa and West Africa, were included. We compared mortality and growth outcomes for different ART initiation criteria, aligned with previous and recent World Health Organization criteria, for 5 years of follow-up, adjusting for all measured baseline and time-dependent confounders using the g-formula. RESULTS: Median (1st;3rd percentile) CD4 count at baseline was 676 cells/mm 3 (394; 1037) (children aged ≥ 1 and 10 years at enrolment we did not find any difference in mortality or growth with immediate ART initiation, with estimated differences of -0.1% (-0.2%; 0.6%) and -0.03 (-0.05; 0.00), respectively. Growth differences in children aged < 10 years persisted for treatment thresholds using higher CD4 values. Regular follow-up led to better height and mortality outcomes. CONCLUSIONS: Immediate ART is associated with lower mortality and better growth for up to 5 years in children < 10 years old. Our results on adolescents were inconclusive.

Thematic Areas: Sociologia i política Serviço social Saúde coletiva Public, environmental & occupational health Odontología Nutrição Medicine (miscellaneous) Medicina iii Medicina ii Medicina i Matemática / probabilidade e estatística Interdisciplinar Geografía General o multidisciplinar General medicine Epidemiology Ensino Enfermagem Educação física Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Ciência da computação Biotecnología Arquitetura e urbanismo Antropologia / arqueologia

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Keyword in other language: Antiretroviral treatment, paediatrics, g-formula, causal inference

ISSN: 03005771

Author's mail: francesc.vidal@urv.cat

Author identifier: 0000-0002-6692-6186

Record's date: 2023-02-18

Papper version: info:eu-repo/semantics/acceptedVersion

Link to the original source: https://academic.oup.com/ije/article/46/2/453/2622841

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: International Journal Of Epidemiology. 46 (2): 453-465

APA: Schomaker M., Leroy V., Wolfs T., Technau K., Renner L., Judd A., Sawry S., Amorissani-Folquet M., Noguera-Julian A., Tanser F., Eboua F., Navarro M., (2017). Optimal timing of antiretroviral treatment initiation in HIV-positive children and adolescents: a multiregional analysis from Southern Africa, West Africa and Europe. International Journal Of Epidemiology, 46(2), 453-465. DOI: 10.1093/ije/dyw097

Article's DOI: 10.1093/ije/dyw097

Entity: Universitat Rovira i Virgili

Journal publication year: 2017

Publication Type: Journal Publications