Mortality and its determinants in antiretroviral treatment-naive HIV-infected children with suspected tuberculosis: an observational cohort study

Marcy, Olivier; Tejiokem, Mathurin Cyrille; Msellati, Philippe; Huu, Khanh Truong; Chau, Viet; Ngoc, Duong Tran; Nacro, Boubacar; Ateba-Ndongo, Francis; Tetang-Ndiang, Suzie; Vibol, Ung; Dim, Bunnet; Neou, Leakhena; Berteloot, Laureline; Borand, Laurence; Delacourt, Christophe; Blanche, Stéphane; Ay, Sao Sarady; Chan, Malen; Chea, Phalla; Goyet, Sophie; Men, Nimul Roat; Pheng, Phearavin; Ramsay, Susan; Suom, Sophea; Tarantola, Arnaud; Te, Naisim; Than, Sreymom; Ung, Sovannary; Chhuk, Chorn; Huot, Chantheany; Kath, Sang Han; Khin, Sokoeun; Kim, Peou; Lim, Kim Eng; Lim, Phary; Lim, Vannareth; Nav, Yany; Pich, Boren; Tuy, Sotharin; Chea, Phal; Chhraing, Sengtray; Chuop, Bophal; Hem, Ramy; Heng, Phanoeurn; Huon, S; Khum, Sokhorn; Liv, Thear; Ly, Vichea; Moch, Makara; Rey, Phanith; Sath, Vina; Sun, Nopheavann; Chat, Pheron; Srey, Viso; Chheang, Sitha; Putchhat, Hor; Oum, Manory; Keo, Monorea; Kou, Sokchea; Cheng, Sokleaph; Kerléguer, Alexandra; Gomgnimbou, Michel K.; Kaboré, Antoinette; Millogo, A; Nikièma, Zakari; Ouedraogo, Abdul Salam; Saidou, Sawadogo; Nouctara, Moumini; Sangare, Diane Ursule; Ouattara,; Sanogo, Bintou; Sié, Edgard Sib; Zingué, Dezemon; Abiguide, Roger Ngoya; Ngo'o, Patrice Assene; Ndongo, Francis Atéba; Balla, S M; Mbouchong, Verlaine Bolyse; Amanya, Jean Marie Ehongo; Eyangoh, Sara; Kaiyven, Afi Leslie; Ndombo, Paul Koki; Bayanak, Samuel Walter Kokola; Kampaing, Marie Josée Mapah; Mangoya, Elizabeth; Mvogo, Minkala; Ndongo, Jean Pierre; Ngassam, L.; Nanda, Francine; Ndjantou, Sylviane; Ndongo, Jean Audrey; Nkoum, Marcelle Njind; Lend, Anne Esther Njom; Nkembe, Angeline; Oyanche, Marie Flore; Taguebue, Jean-Voisin; Tetang-Moyo, Suzy; Zebaze, Sylvie Georgette; Nguyen, Thi Oanh; Nguyen, Tan N.; Quillet, Catherine; Quoc, Khanh Lê; To, My Huong; Tran, Thi Kim Phung; Giang, Chau; Nguyen, Duc Bang; Nguyen, Ngo; Nguyen, Thi Hieu; Nguyen, Thi Thanh Thanh; Tran, Ngoc; Vo, Duy An; Dang, Thi Xuan Lan; Phuong, Thi Kim; Dang, Thi Thanh Tuyen; Nguyen, Hoang Chau; Pham, Ngoc Tuong Vy; Truong, Huu Khanh; Viet, C.; Huynh, Bich Ngoc; Le, Thi Thanh Thuy; Nguyen, Thi Thu Hiep; Tran, Ngoc Luu; Vu, Thien An; Tran, Huu Loc; Nguyen, Manh Hoang; Nguyen, Ngoc Lan; Nguyen, Thi Cao Van; Pham, Thu Hang; Phan, Dinh Quyen; Vo, Thi Ha; Truong, Xuan Lien; Vu, Xuan Thinh; Carcelain, Guislaine; Godreuil, Sylvain; Fournier-Nicolle, Isabelle

doi:10.1016/s2352-3018(17)30206-0

Cited by 21 publications

(15 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The proportion of mortality in this study which is 12.3% is concordant to the studies done in Tanzania (16), Nigeria (17), Malawi (18), South Africa (19), meta-analysis in South Africa (20) and Uganda (21). Furthermore, only slight difference from an observational cohort study conducted in four countries (22) and South Africa (23). This may be due to the similarities in the burden of HIV, TB and HIV/TB coinfection as all study areas are classi ed under high burden countries and the similarities in the age group of study participants may be another reason.…”

Section: Discussionsupporting

confidence: 87%

Predictors of Mortality among TB-HIV Co-Infected Children Attending Anti-Retroviral Therapy Clinics of Selected Public Hospitals in Southern, Ethiopia: Retrospective Cohort Study

Gemechu¹,

Gebremichael²,

Tesfaye³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Co-infection of tuberculosis and HIV has a significant impact on public health. TB is the most common opportunistic infection and the leading cause of death in HIV-positive children worldwide. But there is paucity of studies concerning the predictors of mortality among TB-HIV co-infected children. This study aimed to determine the predictors of mortality among TB-HIV co-infected children attending ART clinics of public hospitals in Southern Nation, Nationalities and Peoples Region (SNNPR), Ethiopia. Methods: A hospital-based retrospective cohort study design was used among 284 TB-HIV co-infected children attending ART clinics at selected public hospitals in SNNPR, Ethiopia, from January 2009 to December 2019. Then, medical records of children who were TB/HIV co-infected and on ART were reviewed using a structured data extraction tool. Data were entered using Epidata 4.6 and analyzed using SPSS version 23. The Kaplan Meier survival curve along with log rank tests was used to estimate and compare survival time. Bivariable and multivariable analyses were conducted to identify predictors of mortality among TB/HIV co-infected children. Adjusted Hazard Ratio with p value < 0.05 and 95 % confidence interval was considered statistically significant.Result: A total of 284 TB/HIV co-infected children were included in the study. Among these, 35 (12.3%) of them died during the study period. The overall mortality rate was 2.78 (95%CI= 1.98-3.99) per 100 child years of observation. The predictors of mortality were anemia (AHR=3.6; 95%CI: 1.39-9.31), fair or poor ART drug adherence (AHR=2.9; 95%CI=1.15-7.43), extra pulmonary TB (AHR=3.9; 95%CI: 1.34-11.45) and TB drug resistance (AHR=5.7; 95%CI: 2.07-15.96). Conclusion: Mortality rate of TB/HIV co-infected children in selected public hospitals in SNNPR, Ethiopia was documented as 2.78 per child years of observation as a result of this study. Moreover, Anemia, drug resistant tuberculosis, extra pulmonary TB and poor adherence to ART drugs were identified as the predictors of mortality among these children.

show abstract

Section: Discussionsupporting

confidence: 87%

Predictors of Mortality among TB-HIV Co-Infected Children Attending Anti-Retroviral Therapy Clinics of Selected Public Hospitals in Southern, Ethiopia: Retrospective Cohort Study

Gemechu¹,

Gebremichael²,

Tesfaye³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…[8][9][10]12 In a cohort of 266 HIV-infected children with suspected tuberculosis (TB) in four countries (Burkina Faso, Cambodia, Cameroon, and Vietnam), Marcy et al found that TB, young age, CD4 less than 10%, miliary features, and elevated serum transaminases were all independent predictors of mortality. 13 In Vietnam, by the end of 2011, there were 3200 Vietnamese children with HIV/AIDS receiving ART; However, there were a few reports on ART outcomes among HIV-infected children [14][15][16] In a study of 86 children on ART in Hanoi, Vietnam, Pham et al reported that the success rate (plasma HIV-1 viral load <1000 copies/mL) was 79.1% after 2-year follow-up. 14 As far as this author knows, no studies to evaluate long-term ART outcomes for infected-HIV children have been conducted in Vietnam.…”

Section: Introductionmentioning

confidence: 99%

<p>Long-Term Outcomes and Risk Factors for Mortality in a Cohort of HIV-Infected Children Receiving Antiretroviral Therapy in Vietnam</p>

Nguyen¹,

Ton²,

Luong³

et al. 2020

HIV

View full text Add to dashboard Cite

Background: Management of HIV-infected children on a long-term basis is a challenge in resource-limited countries. The aim of this study is to evaluate the long-term outcome and identify the risk factors for mortality in a cohort of children with antiretroviral therapy (ART) in Vietnam. Patients and Methods: A retrospective cohort study was conducted in children aged 0-15 years, seen at the outpatient clinic of the Women and Children Hospital of An Giang, Vietnam, from August 2006 to May 2019. Cox proportional-hazard models were used to determine factors associated with mortality. Results: A total of 266 HIV-infected children were on ART. During 1545 child-years of follow-up (median follow-up was 5.8 years), 28 (10.5%) children died yielding a mortality rate of 1.8 death per 100 child-years. By multivariate analysis, World Health Organization clinical stage 3 or 4 (AHR; 7.86, 95% CI; 1.02-60.3, P= 0.047), tuberculosis (TB) coinfection (AHR; 6.26, 95% CI; 2.50-15.64, P= 0.001) and having severe immunosuppression before ART (AHR; 11.73, 95% CI; 1.52-90.4, P= 0.018) were independent factors for mortality in these children. Conclusion: Antiretroviral therapy has reduced mortality in HIV-infected children in resource-limited settings. Independent risk factors for mortality were advanced clinical stage (3 or 4), TB co-infection and severe immunosuppression. Early investigation and treatment of TB co-infection allow early ART initiation which may improve outcomes in our settings.

show abstract

“…In children with severe immunodeficiency, NTM isolation was more frequent, MAC being isolated in more than half of cases, and frequently confirmed on another sample, supporting the hypothesis of NTM-related opportunistic infection in children from our study. However, unlike bacteriologically confirmed TB, which was associated with a 5-fold increase in mortality in ART-naive children in our study despite access to anti-TB treatment, NTM or MAC isolation was not associated with a higher risk of death in children with severe immunodeficiency [12]. In children without severe immunodeficiency, NTM isolation was less frequent, MAC were rare, and only one child had the same species confirmed on a second sample, which is more in favor of environmental exposure and colonization.…”

Section: Discussionmentioning

confidence: 70%

Isolation of Nontuberculous Mycobacteria in Southeast Asian and African Human Immunodeficiency Virus–infected Children With Suspected Tuberculosis

Borand

Lauzanne

Nguyen

et al. 2019

Clinical Infectious Diseases

Self Cite

View full text Add to dashboard Cite

We enrolled 427 human immunodeficiency virus–infected children (median age, 7.3 years), 59.2% severely immunodeficient, with suspected tuberculosis in Southeast Asian and African settings. Nontuberculous mycobacteria were isolated in 46 children (10.8%); 45.7% of isolates were Mycobacterium avium complex. Southeast Asian origin, age 5–9 years, and severe immunodeficiency were independently associated with nontuberculous mycobacteria isolation. Clinical Trials Registration NCT01331811.

show abstract

Mortality and its determinants in antiretroviral treatment-naive HIV-infected children with suspected tuberculosis: an observational cohort study

Cited by 21 publications

References 24 publications

Predictors of Mortality among TB-HIV Co-Infected Children Attending Anti-Retroviral Therapy Clinics of Selected Public Hospitals in Southern, Ethiopia: Retrospective Cohort Study

Predictors of Mortality among TB-HIV Co-Infected Children Attending Anti-Retroviral Therapy Clinics of Selected Public Hospitals in Southern, Ethiopia: Retrospective Cohort Study

<p>Long-Term Outcomes and Risk Factors for Mortality in a Cohort of HIV-Infected Children Receiving Antiretroviral Therapy in Vietnam</p>

Isolation of Nontuberculous Mycobacteria in Southeast Asian and African Human Immunodeficiency Virus–infected Children With Suspected Tuberculosis

Contact Info

Product

Resources

About