Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children aged 1–5 Years: A Causal Modelling Analysis
Identifieur interne : 000197 ( Main/Exploration ); précédent : 000196; suivant : 000198Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children aged 1–5 Years: A Causal Modelling Analysis
Auteurs : Michael Schomaker [Afrique du Sud] ; Mary-Ann Davies [Afrique du Sud] ; Karen Malateste [France] ; Lorna Renner [Ghana] ; Shobna Sawry [Afrique du Sud] ; Sylvie N Beche ; Karl-Günter Technau [Afrique du Sud] ; François Eboua ; Frank Tanser [Afrique du Sud] ; Haby Sygnaté-Sy [Sénégal] ; Sam Phiri [Malawi, États-Unis] ; Madeleine Amorissani-Folquet ; Vivian Cox [Afrique du Sud] ; Fla Koueta [Burkina Faso] ; Cleophas Chimbete [Zimbabwe] ; Annette Lawson-Evi [Togo] ; Janet Giddy [Afrique du Sud] ; Clarisse Amani-Bosse ; Robin Wood [Afrique du Sud] ; Matthias Egger [Suisse, Afrique du Sud] ; Valeriane Leroy [France]Source :
- Epidemiology (Cambridge, Mass.) [ 1044-3983 ] ; 2016.
Descripteurs français
- KwdFr :
- Agents antiVIH (usage thérapeutique), Bases de données factuelles, Burkina, Causalité, Côte d'Ivoire, Développement de l'enfant, Enfant d'âge préscolaire, Facteurs temps, Femelle, Ghana, Humains, Infections à VIH (immunologie), Infections à VIH (mortalité), Infections à VIH (traitement médicamenteux), Intervention médicale précoce, Malawi, Mâle, Nourrisson, Numération des lymphocytes CD4, République d'Afrique du Sud, Sénégal, Thérapie antirétrovirale hautement active (), Togo, Zimbabwe, Études de cohortes.
- MESH :
- immunologie : Infections à VIH.
- mortalité : Infections à VIH.
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Agents antiVIH.
- Bases de données factuelles, Burkina, Causalité, Côte d'Ivoire, Développement de l'enfant, Enfant d'âge préscolaire, Facteurs temps, Femelle, Ghana, Humains, Intervention médicale précoce, Malawi, Mâle, Nourrisson, Numération des lymphocytes CD4, République d'Afrique du Sud, Sénégal, Thérapie antirétrovirale hautement active, Togo, Zimbabwe, Études de cohortes.
English descriptors
- KwdEn :
- Anti-HIV Agents (therapeutic use), Antiretroviral Therapy, Highly Active (methods), Burkina Faso, CD4 Lymphocyte Count, Causality, Child Development, Child, Preschool, Cohort Studies, Cote d'Ivoire, Databases, Factual, Early Medical Intervention, Female, Ghana, HIV Infections (drug therapy), HIV Infections (immunology), HIV Infections (mortality), Humans, Infant, Malawi, Male, Senegal, South Africa, Time Factors, Togo, Zimbabwe.
- MESH :
- chemical , therapeutic use : Anti-HIV Agents.
- drug therapy : HIV Infections.
- immunology : HIV Infections.
- methods : Antiretroviral Therapy, Highly Active.
- mortality : HIV Infections.
- Burkina Faso, CD4 Lymphocyte Count, Causality, Child Development, Child, Preschool, Cohort Studies, Cote d'Ivoire, Databases, Factual, Early Medical Intervention, Female, Ghana, Humans, Infant, Malawi, Male, Senegal, South Africa, Time Factors, Togo, Zimbabwe.
Abstract
There is limited evidence regarding the optimal timing of initiating antiretroviral therapy (ART) in children. We conducted a causal modelling analysis in children aged 1–5 years from the International Epidemiologic Databases to Evaluate AIDS West/Southern-Africa collaboration to determine growth and mortality differences related to different CD4-based treatment initiation criteria, age groups and regions.
ART-naïve children of age 12–59 months at enrollment with at least one visit before ART initiation and one follow-up visit were included. We estimated 3-year growth and cumulative mortality from the start of follow-up for different CD4 criteria using g-computation.
About one quarter of the 5826 included children was from West Africa (24.6%). The median (first; third quartile) CD4% at the first visit was 16% (11%;23%), the median weight-for-age z-scores and height-for-age z-scores were −1.5 (−2.7; −0.6) and −2.5 (−3.5; −1.5), respectively. Estimated cumulative mortality was higher overall, and growth was slower, when initiating ART at lower CD4 thresholds. After 3 years of follow-up, the estimated mortality difference between starting ART routinely irrespective of CD4 count and starting ART if either CD4 count<750 cells/mm3 or CD4%<25% was 0.2% (95%CI: −0.2%;0.3%), and the difference in the mean height-for-age z-scores of those who survived was −0.02 (95%CI: −0.04;0.01). Younger children aged 1–2 and children in West Africa had worse outcomes.
Our results demonstrate that earlier treatment initiation yields overall better growth and mortality outcomes, though we could not show any differences in outcomes between immediate ART and delaying until CD4 count/% falls below750/25%.
Url:
DOI: 10.1097/EDE.0000000000000412
PubMed: 26479876
PubMed Central: 5410645
Affiliations:
- Afrique du Sud, Burkina Faso, France, Ghana, Malawi, Suisse, Sénégal, Togo, Zimbabwe, États-Unis
- Aquitaine, Canton de Berne, Gauteng, Nouvelle-Aquitaine, Région du Grand Accra
- Accra, Berne, Bordeaux, Johannesbourg
- Université de Berne, Université du Witwatersrand
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 000379
- to stream Pmc, to step Curation: 000378
- to stream Pmc, to step Checkpoint: 000094
- to stream PubMed, to step Corpus: 000460
- to stream PubMed, to step Curation: 000460
- to stream PubMed, to step Checkpoint: 000460
- to stream Ncbi, to step Merge: 000897
- to stream Ncbi, to step Curation: 000897
- to stream Ncbi, to step Checkpoint: 000897
- to stream Main, to step Merge: 000197
- to stream Main, to step Curation: 000197
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children aged 1–5 Years: A Causal Modelling Analysis</title><author><name sortKey="Schomaker, Michael" sort="Schomaker, Michael" uniqKey="Schomaker M" first="Michael" last="Schomaker">Michael Schomaker</name><affiliation wicri:level="1"><nlm:aff id="A1">Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Davies, Mary Ann" sort="Davies, Mary Ann" uniqKey="Davies M" first="Mary-Ann" last="Davies">Mary-Ann Davies</name><affiliation wicri:level="1"><nlm:aff id="A1">Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Malateste, Karen" sort="Malateste, Karen" uniqKey="Malateste K" first="Karen" last="Malateste">Karen Malateste</name><affiliation wicri:level="3"><nlm:aff id="A2">University of Bordeaux, Institute of Epidemiology and Public Health, Bordeaux, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University of Bordeaux, Institute of Epidemiology and Public Health, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Renner, Lorna" sort="Renner, Lorna" uniqKey="Renner L" first="Lorna" last="Renner">Lorna Renner</name><affiliation wicri:level="3"><nlm:aff id="A3">University of Ghana Medical School, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>University of Ghana Medical School, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Sawry, Shobna" sort="Sawry, Shobna" uniqKey="Sawry S" first="Shobna" last="Sawry">Shobna Sawry</name><affiliation wicri:level="4"><nlm:aff id="A4">University of the Witwatersrand, Wits Reproductive Health and HIV Institute, Harriet Shezi Children’s Clinic, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>University of the Witwatersrand, Wits Reproductive Health and HIV Institute, Harriet Shezi Children’s Clinic, Chris Hani Baragwanath Academic Hospital, Soweto</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="N Beche, Sylvie" sort="N Beche, Sylvie" uniqKey="N Beche S" first="Sylvie" last="N Beche">Sylvie N Beche</name><affiliation><nlm:aff id="A5">Centre de Prise en Charge de Recherche et de Formation Enfants, Abidjan, Côte d’Ivoire</nlm:aff><wicri:noCountry code="subfield">Côte d’Ivoire</wicri:noCountry></affiliation></author><author><name sortKey="Technau, Karl Gunter" sort="Technau, Karl Gunter" uniqKey="Technau K" first="Karl-Günter" last="Technau">Karl-Günter Technau</name><affiliation wicri:level="4"><nlm:aff id="A6">Empilweni Service and Research Unit, Rahima Moosa Mother and Child Hospital and University of the Witwatersrand, Johannesburg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Empilweni Service and Research Unit, Rahima Moosa Mother and Child Hospital and University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Eboua, Francois" sort="Eboua, Francois" uniqKey="Eboua F" first="François" last="Eboua">François Eboua</name><affiliation><nlm:aff id="A7">Yopougon University Hospital, Abidjan, Côte d’Ivoire</nlm:aff><wicri:noCountry code="subfield">Côte d’Ivoire</wicri:noCountry></affiliation></author><author><name sortKey="Tanser, Frank" sort="Tanser, Frank" uniqKey="Tanser F" first="Frank" last="Tanser">Frank Tanser</name><affiliation wicri:level="1"><nlm:aff id="A8">Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele</wicri:regionArea><wicri:noRegion>Somkhele</wicri:noRegion></affiliation></author><author><name sortKey="Sygnate Sy, Haby" sort="Sygnate Sy, Haby" uniqKey="Sygnate Sy H" first="Haby" last="Sygnaté-Sy">Haby Sygnaté-Sy</name><affiliation wicri:level="1"><nlm:aff id="A9">Albert Royer Hospital, Dakar, Senegal</nlm:aff><country xml:lang="fr">Sénégal</country><wicri:regionArea>Albert Royer Hospital, Dakar</wicri:regionArea><wicri:noRegion>Dakar</wicri:noRegion></affiliation></author><author><name sortKey="Phiri, Sam" sort="Phiri, Sam" uniqKey="Phiri S" first="Sam" last="Phiri">Sam Phiri</name><affiliation wicri:level="1"><nlm:aff id="A10">Lighthouse Trust Clinic, Kamuzu Central Hospital, Lilongwe, Malawi</nlm:aff><country xml:lang="fr">Malawi</country><wicri:regionArea>Lighthouse Trust Clinic, Kamuzu Central Hospital, Lilongwe</wicri:regionArea><wicri:noRegion>Lilongwe</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A11">University of North Carolina, Chapel Hill, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of North Carolina, Chapel Hill</wicri:regionArea><wicri:noRegion>Chapel Hill</wicri:noRegion></affiliation></author><author><name sortKey="Amorissani Folquet, Madeleine" sort="Amorissani Folquet, Madeleine" uniqKey="Amorissani Folquet M" first="Madeleine" last="Amorissani-Folquet">Madeleine Amorissani-Folquet</name><affiliation><nlm:aff id="A12">Félix Houphouët Boigny University Hospital, Abidjan, Côte d’Ivoire</nlm:aff><wicri:noCountry code="subfield">Côte d’Ivoire</wicri:noCountry></affiliation></author><author><name sortKey="Cox, Vivian" sort="Cox, Vivian" uniqKey="Cox V" first="Vivian" last="Cox">Vivian Cox</name><affiliation wicri:level="1"><nlm:aff id="A13">Médecins Sans Frontiéres South Africa, CapeTown, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Médecins Sans Frontiéres South Africa, CapeTown</wicri:regionArea><wicri:noRegion>CapeTown</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A14">Khayelitsha ART Programme, Khayelitsha, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Khayelitsha ART Programme, Khayelitsha, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Koueta, Fla" sort="Koueta, Fla" uniqKey="Koueta F" first="Fla" last="Koueta">Fla Koueta</name><affiliation wicri:level="1"><nlm:aff id="A15">Charles de Gaulle University Hospital, Ouagadougou, Burkina Faso</nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Charles de Gaulle University Hospital, Ouagadougou</wicri:regionArea><wicri:noRegion>Ouagadougou</wicri:noRegion></affiliation></author><author><name sortKey="Chimbete, Cleophas" sort="Chimbete, Cleophas" uniqKey="Chimbete C" first="Cleophas" last="Chimbete">Cleophas Chimbete</name><affiliation wicri:level="1"><nlm:aff id="A16">Newlands Clinic, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>Newlands Clinic, Harare</wicri:regionArea><wicri:noRegion>Harare</wicri:noRegion></affiliation></author><author><name sortKey="Lawson Evi, Annette" sort="Lawson Evi, Annette" uniqKey="Lawson Evi A" first="Annette" last="Lawson-Evi">Annette Lawson-Evi</name><affiliation wicri:level="1"><nlm:aff id="A17">Hospital du Tokoin, Lomé, Togo</nlm:aff><country xml:lang="fr">Togo</country><wicri:regionArea>Hospital du Tokoin, Lomé</wicri:regionArea><wicri:noRegion>Lomé</wicri:noRegion></affiliation></author><author><name sortKey="Giddy, Janet" sort="Giddy, Janet" uniqKey="Giddy J" first="Janet" last="Giddy">Janet Giddy</name><affiliation wicri:level="1"><nlm:aff id="A18">Sinikithemba Clinic, McCord Hospital, Durban, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Sinikithemba Clinic, McCord Hospital, Durban</wicri:regionArea><wicri:noRegion>Durban</wicri:noRegion></affiliation></author><author><name sortKey="Amani Bosse, Clarisse" sort="Amani Bosse, Clarisse" uniqKey="Amani Bosse C" first="Clarisse" last="Amani-Bosse">Clarisse Amani-Bosse</name><affiliation><nlm:aff id="A19">MTCT-Plus Center, Abidjan, Côte d’Ivoire</nlm:aff><wicri:noCountry code="subfield">Côte d’Ivoire</wicri:noCountry></affiliation></author><author><name sortKey="Wood, Robin" sort="Wood, Robin" uniqKey="Wood R" first="Robin" last="Wood">Robin Wood</name><affiliation wicri:level="1"><nlm:aff id="A20">Desmond Tutu HIV Centre, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Desmond Tutu HIV Centre, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A21">Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Egger, Matthias" sort="Egger, Matthias" uniqKey="Egger M" first="Matthias" last="Egger">Matthias Egger</name><affiliation wicri:level="4"><nlm:aff id="A22">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName><orgName type="university">Université de Berne</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="A1">Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Leroy, Valeriane" sort="Leroy, Valeriane" uniqKey="Leroy V" first="Valeriane" last="Leroy">Valeriane Leroy</name><affiliation wicri:level="3"><nlm:aff id="A2">University of Bordeaux, Institute of Epidemiology and Public Health, Bordeaux, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University of Bordeaux, Institute of Epidemiology and Public Health, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="A23">Inserm, U897, Epidémiologie–Biostatistiques, Université Bordeaux, Bordeaux, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Inserm, U897, Epidémiologie–Biostatistiques, Université Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26479876</idno><idno type="pmc">5410645</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410645</idno><idno type="RBID">PMC:5410645</idno><idno type="doi">10.1097/EDE.0000000000000412</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000379</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000379</idno><idno type="wicri:Area/Pmc/Curation">000378</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000378</idno><idno type="wicri:Area/Pmc/Checkpoint">000094</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000094</idno><idno type="wicri:source">PubMed</idno><idno type="wicri:Area/PubMed/Corpus">000460</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000460</idno><idno type="wicri:Area/PubMed/Curation">000460</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000460</idno><idno type="wicri:Area/PubMed/Checkpoint">000460</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000460</idno><idno type="wicri:Area/Ncbi/Merge">000897</idno><idno type="wicri:Area/Ncbi/Curation">000897</idno><idno type="wicri:Area/Ncbi/Checkpoint">000897</idno><idno type="wicri:doubleKey">1044-3983:2016:Schomaker M:growth:and:mortality</idno><idno type="wicri:Area/Main/Merge">000197</idno><idno type="wicri:Area/Main/Curation">000197</idno><idno type="wicri:Area/Main/Exploration">000197</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children aged 1–5 Years: A Causal Modelling Analysis</title><author><name sortKey="Schomaker, Michael" sort="Schomaker, Michael" uniqKey="Schomaker M" first="Michael" last="Schomaker">Michael Schomaker</name><affiliation wicri:level="1"><nlm:aff id="A1">Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Davies, Mary Ann" sort="Davies, Mary Ann" uniqKey="Davies M" first="Mary-Ann" last="Davies">Mary-Ann Davies</name><affiliation wicri:level="1"><nlm:aff id="A1">Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Malateste, Karen" sort="Malateste, Karen" uniqKey="Malateste K" first="Karen" last="Malateste">Karen Malateste</name><affiliation wicri:level="3"><nlm:aff id="A2">University of Bordeaux, Institute of Epidemiology and Public Health, Bordeaux, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University of Bordeaux, Institute of Epidemiology and Public Health, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Renner, Lorna" sort="Renner, Lorna" uniqKey="Renner L" first="Lorna" last="Renner">Lorna Renner</name><affiliation wicri:level="3"><nlm:aff id="A3">University of Ghana Medical School, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>University of Ghana Medical School, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Sawry, Shobna" sort="Sawry, Shobna" uniqKey="Sawry S" first="Shobna" last="Sawry">Shobna Sawry</name><affiliation wicri:level="4"><nlm:aff id="A4">University of the Witwatersrand, Wits Reproductive Health and HIV Institute, Harriet Shezi Children’s Clinic, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>University of the Witwatersrand, Wits Reproductive Health and HIV Institute, Harriet Shezi Children’s Clinic, Chris Hani Baragwanath Academic Hospital, Soweto</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="N Beche, Sylvie" sort="N Beche, Sylvie" uniqKey="N Beche S" first="Sylvie" last="N Beche">Sylvie N Beche</name><affiliation><nlm:aff id="A5">Centre de Prise en Charge de Recherche et de Formation Enfants, Abidjan, Côte d’Ivoire</nlm:aff><wicri:noCountry code="subfield">Côte d’Ivoire</wicri:noCountry></affiliation></author><author><name sortKey="Technau, Karl Gunter" sort="Technau, Karl Gunter" uniqKey="Technau K" first="Karl-Günter" last="Technau">Karl-Günter Technau</name><affiliation wicri:level="4"><nlm:aff id="A6">Empilweni Service and Research Unit, Rahima Moosa Mother and Child Hospital and University of the Witwatersrand, Johannesburg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Empilweni Service and Research Unit, Rahima Moosa Mother and Child Hospital and University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Eboua, Francois" sort="Eboua, Francois" uniqKey="Eboua F" first="François" last="Eboua">François Eboua</name><affiliation><nlm:aff id="A7">Yopougon University Hospital, Abidjan, Côte d’Ivoire</nlm:aff><wicri:noCountry code="subfield">Côte d’Ivoire</wicri:noCountry></affiliation></author><author><name sortKey="Tanser, Frank" sort="Tanser, Frank" uniqKey="Tanser F" first="Frank" last="Tanser">Frank Tanser</name><affiliation wicri:level="1"><nlm:aff id="A8">Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele</wicri:regionArea><wicri:noRegion>Somkhele</wicri:noRegion></affiliation></author><author><name sortKey="Sygnate Sy, Haby" sort="Sygnate Sy, Haby" uniqKey="Sygnate Sy H" first="Haby" last="Sygnaté-Sy">Haby Sygnaté-Sy</name><affiliation wicri:level="1"><nlm:aff id="A9">Albert Royer Hospital, Dakar, Senegal</nlm:aff><country xml:lang="fr">Sénégal</country><wicri:regionArea>Albert Royer Hospital, Dakar</wicri:regionArea><wicri:noRegion>Dakar</wicri:noRegion></affiliation></author><author><name sortKey="Phiri, Sam" sort="Phiri, Sam" uniqKey="Phiri S" first="Sam" last="Phiri">Sam Phiri</name><affiliation wicri:level="1"><nlm:aff id="A10">Lighthouse Trust Clinic, Kamuzu Central Hospital, Lilongwe, Malawi</nlm:aff><country xml:lang="fr">Malawi</country><wicri:regionArea>Lighthouse Trust Clinic, Kamuzu Central Hospital, Lilongwe</wicri:regionArea><wicri:noRegion>Lilongwe</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A11">University of North Carolina, Chapel Hill, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of North Carolina, Chapel Hill</wicri:regionArea><wicri:noRegion>Chapel Hill</wicri:noRegion></affiliation></author><author><name sortKey="Amorissani Folquet, Madeleine" sort="Amorissani Folquet, Madeleine" uniqKey="Amorissani Folquet M" first="Madeleine" last="Amorissani-Folquet">Madeleine Amorissani-Folquet</name><affiliation><nlm:aff id="A12">Félix Houphouët Boigny University Hospital, Abidjan, Côte d’Ivoire</nlm:aff><wicri:noCountry code="subfield">Côte d’Ivoire</wicri:noCountry></affiliation></author><author><name sortKey="Cox, Vivian" sort="Cox, Vivian" uniqKey="Cox V" first="Vivian" last="Cox">Vivian Cox</name><affiliation wicri:level="1"><nlm:aff id="A13">Médecins Sans Frontiéres South Africa, CapeTown, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Médecins Sans Frontiéres South Africa, CapeTown</wicri:regionArea><wicri:noRegion>CapeTown</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A14">Khayelitsha ART Programme, Khayelitsha, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Khayelitsha ART Programme, Khayelitsha, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Koueta, Fla" sort="Koueta, Fla" uniqKey="Koueta F" first="Fla" last="Koueta">Fla Koueta</name><affiliation wicri:level="1"><nlm:aff id="A15">Charles de Gaulle University Hospital, Ouagadougou, Burkina Faso</nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Charles de Gaulle University Hospital, Ouagadougou</wicri:regionArea><wicri:noRegion>Ouagadougou</wicri:noRegion></affiliation></author><author><name sortKey="Chimbete, Cleophas" sort="Chimbete, Cleophas" uniqKey="Chimbete C" first="Cleophas" last="Chimbete">Cleophas Chimbete</name><affiliation wicri:level="1"><nlm:aff id="A16">Newlands Clinic, Harare, Zimbabwe</nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>Newlands Clinic, Harare</wicri:regionArea><wicri:noRegion>Harare</wicri:noRegion></affiliation></author><author><name sortKey="Lawson Evi, Annette" sort="Lawson Evi, Annette" uniqKey="Lawson Evi A" first="Annette" last="Lawson-Evi">Annette Lawson-Evi</name><affiliation wicri:level="1"><nlm:aff id="A17">Hospital du Tokoin, Lomé, Togo</nlm:aff><country xml:lang="fr">Togo</country><wicri:regionArea>Hospital du Tokoin, Lomé</wicri:regionArea><wicri:noRegion>Lomé</wicri:noRegion></affiliation></author><author><name sortKey="Giddy, Janet" sort="Giddy, Janet" uniqKey="Giddy J" first="Janet" last="Giddy">Janet Giddy</name><affiliation wicri:level="1"><nlm:aff id="A18">Sinikithemba Clinic, McCord Hospital, Durban, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Sinikithemba Clinic, McCord Hospital, Durban</wicri:regionArea><wicri:noRegion>Durban</wicri:noRegion></affiliation></author><author><name sortKey="Amani Bosse, Clarisse" sort="Amani Bosse, Clarisse" uniqKey="Amani Bosse C" first="Clarisse" last="Amani-Bosse">Clarisse Amani-Bosse</name><affiliation><nlm:aff id="A19">MTCT-Plus Center, Abidjan, Côte d’Ivoire</nlm:aff><wicri:noCountry code="subfield">Côte d’Ivoire</wicri:noCountry></affiliation></author><author><name sortKey="Wood, Robin" sort="Wood, Robin" uniqKey="Wood R" first="Robin" last="Wood">Robin Wood</name><affiliation wicri:level="1"><nlm:aff id="A20">Desmond Tutu HIV Centre, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Desmond Tutu HIV Centre, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A21">Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Egger, Matthias" sort="Egger, Matthias" uniqKey="Egger M" first="Matthias" last="Egger">Matthias Egger</name><affiliation wicri:level="4"><nlm:aff id="A22">Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName><orgName type="university">Université de Berne</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="A1">Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Leroy, Valeriane" sort="Leroy, Valeriane" uniqKey="Leroy V" first="Valeriane" last="Leroy">Valeriane Leroy</name><affiliation wicri:level="3"><nlm:aff id="A2">University of Bordeaux, Institute of Epidemiology and Public Health, Bordeaux, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University of Bordeaux, Institute of Epidemiology and Public Health, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="A23">Inserm, U897, Epidémiologie–Biostatistiques, Université Bordeaux, Bordeaux, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Inserm, U897, Epidémiologie–Biostatistiques, Université Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author></analytic><series><title level="j">Epidemiology (Cambridge, Mass.)</title><idno type="ISSN">1044-3983</idno><idno type="eISSN">1531-5487</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anti-HIV Agents (therapeutic use)</term><term>Antiretroviral Therapy, Highly Active (methods)</term><term>Burkina Faso</term><term>CD4 Lymphocyte Count</term><term>Causality</term><term>Child Development</term><term>Child, Preschool</term><term>Cohort Studies</term><term>Cote d'Ivoire</term><term>Databases, Factual</term><term>Early Medical Intervention</term><term>Female</term><term>Ghana</term><term>HIV Infections (drug therapy)</term><term>HIV Infections (immunology)</term><term>HIV Infections (mortality)</term><term>Humans</term><term>Infant</term><term>Malawi</term><term>Male</term><term>Senegal</term><term>South Africa</term><term>Time Factors</term><term>Togo</term><term>Zimbabwe</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Agents antiVIH (usage thérapeutique)</term><term>Bases de données factuelles</term><term>Burkina</term><term>Causalité</term><term>Côte d'Ivoire</term><term>Développement de l'enfant</term><term>Enfant d'âge préscolaire</term><term>Facteurs temps</term><term>Femelle</term><term>Ghana</term><term>Humains</term><term>Infections à VIH (immunologie)</term><term>Infections à VIH (mortalité)</term><term>Infections à VIH (traitement médicamenteux)</term><term>Intervention médicale précoce</term><term>Malawi</term><term>Mâle</term><term>Nourrisson</term><term>Numération des lymphocytes CD4</term><term>République d'Afrique du Sud</term><term>Sénégal</term><term>Thérapie antirétrovirale hautement active ()</term><term>Togo</term><term>Zimbabwe</term><term>Études de cohortes</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-HIV Agents</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Antiretroviral Therapy, Highly Active</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Agents antiVIH</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Burkina Faso</term><term>CD4 Lymphocyte Count</term><term>Causality</term><term>Child Development</term><term>Child, Preschool</term><term>Cohort Studies</term><term>Cote d'Ivoire</term><term>Databases, Factual</term><term>Early Medical Intervention</term><term>Female</term><term>Ghana</term><term>Humans</term><term>Infant</term><term>Malawi</term><term>Male</term><term>Senegal</term><term>South Africa</term><term>Time Factors</term><term>Togo</term><term>Zimbabwe</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Bases de données factuelles</term><term>Burkina</term><term>Causalité</term><term>Côte d'Ivoire</term><term>Développement de l'enfant</term><term>Enfant d'âge préscolaire</term><term>Facteurs temps</term><term>Femelle</term><term>Ghana</term><term>Humains</term><term>Intervention médicale précoce</term><term>Malawi</term><term>Mâle</term><term>Nourrisson</term><term>Numération des lymphocytes CD4</term><term>République d'Afrique du Sud</term><term>Sénégal</term><term>Thérapie antirétrovirale hautement active</term><term>Togo</term><term>Zimbabwe</term><term>Études de cohortes</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">There is limited evidence regarding the optimal timing of initiating antiretroviral therapy (ART) in children. We conducted a causal modelling analysis in children aged 1–5 years from the International Epidemiologic Databases to Evaluate AIDS West/Southern-Africa collaboration to determine growth and mortality differences related to different CD4-based treatment initiation criteria, age groups and regions.</p></sec><sec id="S2"><title>Methods</title><p id="P2">ART-naïve children of age 12–59 months at enrollment with at least one visit before ART initiation and one follow-up visit were included. We estimated 3-year growth and cumulative mortality from the start of follow-up for different CD4 criteria using g-computation.</p></sec><sec id="S3"><title>Results</title><p id="P3">About one quarter of the 5826 included children was from West Africa (24.6%). The median (first; third quartile) CD4% at the first visit was 16% (11%;23%), the median weight-for-age z-scores and height-for-age z-scores were −1.5 (−2.7; −0.6) and −2.5 (−3.5; −1.5), respectively. Estimated cumulative mortality was higher overall, and growth was slower, when initiating ART at lower CD4 thresholds. After 3 years of follow-up, the estimated mortality difference between starting ART routinely irrespective of CD4 count and starting ART if either CD4 count<750 cells/mm<sup>3</sup> or CD4%<25% was 0.2% (95%CI: −0.2%;0.3%), and the difference in the mean height-for-age z-scores of those who survived was −0.02 (95%CI: −0.04;0.01). Younger children aged 1–2 and children in West Africa had worse outcomes.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Our results demonstrate that earlier treatment initiation yields overall better growth and mortality outcomes, though we could not show any differences in outcomes between immediate ART and delaying until CD4 count/% falls below750/25%.</p></sec></div></front></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Burkina Faso</li><li>France</li><li>Ghana</li><li>Malawi</li><li>Suisse</li><li>Sénégal</li><li>Togo</li><li>Zimbabwe</li><li>États-Unis</li></country><region><li>Aquitaine</li><li>Canton de Berne</li><li>Gauteng</li><li>Nouvelle-Aquitaine</li><li>Région du Grand Accra</li></region><settlement><li>Accra</li><li>Berne</li><li>Bordeaux</li><li>Johannesbourg</li></settlement><orgName><li>Université de Berne</li><li>Université du Witwatersrand</li></orgName></list><tree><noCountry><name sortKey="Amani Bosse, Clarisse" sort="Amani Bosse, Clarisse" uniqKey="Amani Bosse C" first="Clarisse" last="Amani-Bosse">Clarisse Amani-Bosse</name><name sortKey="Amorissani Folquet, Madeleine" sort="Amorissani Folquet, Madeleine" uniqKey="Amorissani Folquet M" first="Madeleine" last="Amorissani-Folquet">Madeleine Amorissani-Folquet</name><name sortKey="Eboua, Francois" sort="Eboua, Francois" uniqKey="Eboua F" first="François" last="Eboua">François Eboua</name><name sortKey="N Beche, Sylvie" sort="N Beche, Sylvie" uniqKey="N Beche S" first="Sylvie" last="N Beche">Sylvie N Beche</name></noCountry><country name="Afrique du Sud"><noRegion><name sortKey="Schomaker, Michael" sort="Schomaker, Michael" uniqKey="Schomaker M" first="Michael" last="Schomaker">Michael Schomaker</name></noRegion><name sortKey="Cox, Vivian" sort="Cox, Vivian" uniqKey="Cox V" first="Vivian" last="Cox">Vivian Cox</name><name sortKey="Cox, Vivian" sort="Cox, Vivian" uniqKey="Cox V" first="Vivian" last="Cox">Vivian Cox</name><name sortKey="Davies, Mary Ann" sort="Davies, Mary Ann" uniqKey="Davies M" first="Mary-Ann" last="Davies">Mary-Ann Davies</name><name sortKey="Egger, Matthias" sort="Egger, Matthias" uniqKey="Egger M" first="Matthias" last="Egger">Matthias Egger</name><name sortKey="Giddy, Janet" sort="Giddy, Janet" uniqKey="Giddy J" first="Janet" last="Giddy">Janet Giddy</name><name sortKey="Sawry, Shobna" sort="Sawry, Shobna" uniqKey="Sawry S" first="Shobna" last="Sawry">Shobna Sawry</name><name sortKey="Tanser, Frank" sort="Tanser, Frank" uniqKey="Tanser F" first="Frank" last="Tanser">Frank Tanser</name><name sortKey="Technau, Karl Gunter" sort="Technau, Karl Gunter" uniqKey="Technau K" first="Karl-Günter" last="Technau">Karl-Günter Technau</name><name sortKey="Wood, Robin" sort="Wood, Robin" uniqKey="Wood R" first="Robin" last="Wood">Robin Wood</name><name sortKey="Wood, Robin" sort="Wood, Robin" uniqKey="Wood R" first="Robin" last="Wood">Robin Wood</name></country><country name="France"><region name="Nouvelle-Aquitaine"><name sortKey="Malateste, Karen" sort="Malateste, Karen" uniqKey="Malateste K" first="Karen" last="Malateste">Karen Malateste</name></region><name sortKey="Leroy, Valeriane" sort="Leroy, Valeriane" uniqKey="Leroy V" first="Valeriane" last="Leroy">Valeriane Leroy</name><name sortKey="Leroy, Valeriane" sort="Leroy, Valeriane" uniqKey="Leroy V" first="Valeriane" last="Leroy">Valeriane Leroy</name></country><country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Renner, Lorna" sort="Renner, Lorna" uniqKey="Renner L" first="Lorna" last="Renner">Lorna Renner</name></region></country><country name="Sénégal"><noRegion><name sortKey="Sygnate Sy, Haby" sort="Sygnate Sy, Haby" uniqKey="Sygnate Sy H" first="Haby" last="Sygnaté-Sy">Haby Sygnaté-Sy</name></noRegion></country><country name="Malawi"><noRegion><name sortKey="Phiri, Sam" sort="Phiri, Sam" uniqKey="Phiri S" first="Sam" last="Phiri">Sam Phiri</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Phiri, Sam" sort="Phiri, Sam" uniqKey="Phiri S" first="Sam" last="Phiri">Sam Phiri</name></noRegion></country><country name="Burkina Faso"><noRegion><name sortKey="Koueta, Fla" sort="Koueta, Fla" uniqKey="Koueta F" first="Fla" last="Koueta">Fla Koueta</name></noRegion></country><country name="Zimbabwe"><noRegion><name sortKey="Chimbete, Cleophas" sort="Chimbete, Cleophas" uniqKey="Chimbete C" first="Cleophas" last="Chimbete">Cleophas Chimbete</name></noRegion></country><country name="Togo"><noRegion><name sortKey="Lawson Evi, Annette" sort="Lawson Evi, Annette" uniqKey="Lawson Evi A" first="Annette" last="Lawson-Evi">Annette Lawson-Evi</name></noRegion></country><country name="Suisse"><region name="Canton de Berne"><name sortKey="Egger, Matthias" sort="Egger, Matthias" uniqKey="Egger M" first="Matthias" last="Egger">Matthias Egger</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaGhanaV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000197 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000197 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= SidaGhanaV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= PMC:5410645
|texte= Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children aged 1–5 Years: A Causal Modelling Analysis
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:26479876" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a SidaGhanaV1
| This area was generated with Dilib version V0.6.31. |  |