Autor según el artículo: 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.
Departamento: Medicina i Cirurgia
Autor/es de la URV: Vidal Marsal, Francisco
Palabras clave: Paediatrics G-formula Causal inference Antiretroviral treatment g-formula causal inference antiretroviral treatment
Resumen: 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.
Áreas temáticas: 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
Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
Palabra clave otro idioma: Antiretroviral treatment, paediatrics, g-formula, causal inference
ISSN: 03005771
Direcció de correo del autor: francesc.vidal@urv.cat
Identificador del autor: 0000-0002-6692-6186
Fecha de alta del registro: 2024-09-07
Versión del articulo depositado: info:eu-repo/semantics/acceptedVersion
Enlace a la fuente original: https://academic.oup.com/ije/article/46/2/453/2622841
URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
Referencia al articulo segun fuente origial: International Journal Of Epidemiology. 46 (2): 453-465
Referencia de l'ítem segons les normes 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
DOI del artículo: 10.1093/ije/dyw097
Entidad: Universitat Rovira i Virgili
Año de publicación de la revista: 2017
Tipo de publicación: Journal Publications