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: 2024-09-07
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: https://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