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  • Ovid Technologies (Wolters Kluwer Health)  (2)
  • Van Nguyen, Lam  (2)
  • 2020-2024  (2)
  • 1
    Online Resource
    Online Resource
    Determining standardized causes of death of infants, children, and adolescents living with HIV in Asia
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  AIDS Vol. 34, No. 10 ( 2020-08-1), p. 1527-1537
    Details
    In: AIDS, Ovid Technologies (Wolters Kluwer Health), Vol. 34, No. 10 ( 2020-08-1), p. 1527-1537
    Abstract: To implement a standardized cause of death reporting and review process to systematically disaggregate causes of HIV-related deaths in a cohort of Asian children and adolescents. Design: Death-related data were retrospectively and prospectively assessed in a longitudinal regional cohort study. Methods: Children under routine HIV care at sites in Cambodia, India, Indonesia, Malaysia, Thailand, and Vietnam between 2008 and 2017 were followed. Causes of death were reported and then independently and centrally reviewed. Predictors were compared using competing risks survival regression analyses. Results: Among 5918 children, 5523 (93%; 52% male) had ever been on combination antiretroviral therapy. Of 371 (6.3%) deaths, 312 (84%) occurred in those with a history of combination antiretroviral therapy (crude all-cause mortality 9.6 per 1000 person-years; total follow-up time 32 361 person-years). In this group, median age at death was 7.0 (2.9–13) years; median CD4 + cell count was 73 (16–325) cells/μl. The most common underlying causes of death were pneumonia due to unspecified pathogens (17%), tuberculosis (16%), sepsis (8.0%), and AIDS (6.7%); 12% of causes were unknown. These clinical diagnoses were further grouped into AIDS-related infections (22%) and noninfections (5.8%), and non-AIDS-related infections (47%) and noninfections (11%); with 12% unknown, 2.2% not reviewed. Higher CD4 + cell count and better weight-for-age z -score were protective against death. Conclusion: Our standardized cause of death assessment provides robust data to inform regional resource allocation for pediatric diagnostic evaluations and prioritization of clinical interventions, and highlight the continued importance of opportunistic and nonopportunistic infections as causes of death in our cohort.
    Type of Medium: Online Resource
    ISSN: 0269-9370 , 1473-5571
    URL: Article
    DOI: 10.1097/QAD.0000000000002583
    RVK:
    XA 16838
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 639076-6
    detail.hit.zdb_id: 2012212-3
    Location Call Number Limitation Availability
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  • 2
    Online Resource
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    Severe Recurrent Bacterial Pneumonia Among Children Living With HIV
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Pediatric Infectious Disease Journal Vol. 41, No. 5 ( 2022-05), p. e208-e215
    Details
    In: Pediatric Infectious Disease Journal, Ovid Technologies (Wolters Kluwer Health), Vol. 41, No. 5 ( 2022-05), p. e208-e215
    Abstract: Bacterial pneumonia imparts a major morbidity and mortality burden on children living with HIV, yet effective prevention and treatment options are underutilized. We explored clinical factors associated with severe recurrent bacterial pneumonia among children living with HIV. Methods: Children enrolled in the TREAT Asia Pediatric HIV Observational Database were included if they started antiretroviral therapy (ART) on or after January 1st, 2008. Factors associated with severe recurrent bacterial pneumonia were assessed using competing-risk regression. Results: A total of 3,944 children were included in the analysis; 136 cases of severe recurrent bacterial pneumonia were reported at a rate of 6.5 [95% confidence interval (CI): 5.5–7.7] events per 1,000 patient-years. Clinical factors associated with severe recurrent bacterial pneumonia were younger age [adjusted subdistribution hazard ratio (aHR): 4.4 for 〈 5 years versus ≥10 years, 95% CI: 2.2–8.4, P 〈 0.001], lower weight-for-age z-score (aHR: 1.5 for 〈 −3.0 versus 〉 −2.0, 95% CI: 1.1–2.3, P = 0.024), pre-ART diagnosis of severe recurrent bacterial pneumonia (aHR: 4.0 versus no pre-ART diagnosis, 95% CI: 2.7−5.8, P 〈 0.001), past diagnosis of symptomatic lymphoid interstitial pneumonitis or chronic HIV-associated lung disease, including bronchiectasis (aHR: 4.8 versus no past diagnosis, 95% CI: 2.8−8.4, P 〈 0.001), low CD4% (aHR: 3.5 for 〈 10% versus ≥25%, 95% CI: 1.9−6.4, P 〈 0.001) and detectable HIV viral load (aHR: 2.6 versus undetectable, 95% CI: 1.2−5.9, P = 0.018). Conclusions: Children 〈 10-years-old and those with low weight-for-age, a history of respiratory illness, low CD4% or poorly controlled HIV are likely to gain the greatest benefit from targeted prevention and treatment programs to reduce the burden of bacterial pneumonia in children living with HIV.
    Type of Medium: Online Resource
    ISSN: 0891-3668
    URL: Article
    DOI: 10.1097/INF.0000000000003494
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 392481-6
    Location Call Number Limitation Availability
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