Articles producció científica> Medicina i Cirurgia

Optimal timing of antiretroviral treatment initiation in HIV-positive children and adolescents: a multiregional analysis from Southern Africa, West Africa and Europe

  • Identification data

    Identifier: imarina:5130924
    Authors:
    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.
    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.
  • Others:

    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
  • Keywords:

    Epidemiology,Medicine (Miscellaneous),Public, Environmental & Occupational Health
    Paediatrics
    G-formula
    Causal inference
    Antiretroviral treatment
    g-formula
    causal inference
    antiretroviral treatment
    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
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