Publication Date
2-1-2024
Journal
International Journal of Infectious Diseases
DOI
10.1016/j.ijid.2023.11.030
PMID
38036259
PMCID
PMC10843817
PubMedCentral® Posted Date
2-5-2024
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Adult, Humans, Child, Retrospective Studies, Thinness, Botswana, Uganda, HIV Infections, Risk Factors, Disease Progression, LTNP, HIV progression, Pediatric, Africa
Abstract
OBJECTIVES: We utilize a large retrospective study cohort derived from electronic medical records to estimate the prevalence of long-term non-progression (LTNP) and determine the factors associated with progression among children infected with HIV in Botswana and Uganda.
METHODS: Electronic medical records from large tertiary HIV clinical centers in Botswana and Uganda were queried to identify LTNP children 0-18 years enrolled between June 2003 and May 2014 and extract demographic and nutritional parameters. Multivariate subdistribution hazard analyses were used to examine demographic factors and nutritional status in progression in the pre-antiretroviral therapy era.
RESULTS: Between the two countries, 14,246 antiretroviral therapy-naïve children infected with HIV were enrolled into clinical care. The overall proportion of LTNP was 6.3% (9.5% in Botswana vs 5.9% in Uganda). The median progression-free survival for the cohort was 6.3 years, although this was lower in Botswana than in Uganda (6.6 vs 8.8 years; P
CONCLUSIONS: In our study, the prevalence of pediatric LTNP was lower than that observed among adult populations, but progression-free survival was higher than expected. Underweight, year of enrollment into care, and country of origin are independent predictors of progression among children.
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