Gender Differences in Lymphocyte Populations, Plasma HIV RNA Levels, and Disease Progression in a Cohort of Children Born to Women Infected With HIV

Foca, Marc; Moye, John; Chu, Clara; Matthews, Yvonne; Rich, Ken; Handelsman, Edward; Luzuriaga, Katherine; Paul, Mary E.; Díaz, Clemente

doi:10.1542/peds.2005-0294

Cited by 24 publications

(31 citation statements)

References 31 publications

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“…It is also conceivable that some children that were lost to follow-up had actually died, which might have affected both the validity and precision of our estimate as pointed out by an earlier systemic analysis done in 2009 [58]. However, a recent systemic review in 2017 suggests that more of sub-Saharan HIV-infected patients that are lost to follow-up are surviving better [59].…”

Section: Limitations Of the Studymentioning

confidence: 99%

Mortality in a Cohort of HIV-Infected Children: A 12-Month Outcome of Antiretroviral Therapy in Makurdi, Nigeria

Anígilájé

Aderibigbe

2018

Advances in Medicine

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Introduction Recognizing the predictors of mortality among HIV-infected children will allow for concerted management that can reduce HIV-mortality in Nigeria. Methodology A retrospective cohort study in children aged 0–15 years, between October 2010 and December 2013, at the Federal Medical Centre, Makurdi, Nigeria. Kaplan–Meier method analysed the cumulative probability of early mortality (EM) occurring at or before 6 months and after 6 months of follow-up (late mortality-LM) on a 12-month antiretroviral therapy (ART). Multivariate Cox proportional regression models were used to test for hazard ratios (HR). Results 368 children were included in the analysis contributing 81 children per 100 child-years to the 12-month ART follow-up. A significant reduction in EM rates was noted at 17.3 deaths per 100 child-years (30 deaths) to LM rates of 3.0 deaths per 100 child-years (10 deaths), p < 0.01. At multivariate analysis, children with a high pretreatment viral load (≥10,000 copies/ml) were found to be at risk of EM (aHR; 18. 089, 95% CI; 2.428–134.77, p=0.005). Having severe immunosuppression at/or before 6 months of ART was the predictor of LM (aHR; 17.28, 95% CI; 3.844–77.700, p ≤ 0.001). Conclusions Although a lower mortality rate is seen at 12 months of ART in our setting, predictors of HIV mortality are having high pretreatment HIV viral load and severe immunosuppression. While primary prevention of HIV infection is paramount, early identification of these predictors among our HIV-infected children for an early ART initiation can reduce further the mortality in our setting. In addition, measures to ensure a good standard of care and retention in care for a sustained virologic suppression cannot be ignored and are hereby underscored.

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Section: Limitations Of the Studymentioning

confidence: 99%

Mortality in a Cohort of HIV-Infected Children: A 12-Month Outcome of Antiretroviral Therapy in Makurdi, Nigeria

Anígilájé

Aderibigbe

2018

Advances in Medicine

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“…Also, the antiretroviral (ARV) prophylaxis of vertical transmission can act on the placental environment, causing changes in cytokine expression (9). The newborns present abnormalities in mitochondrial function (2), in hematological features (5,10,17), and in the maturation of T and B lymphocytes (3,4,8,11,12,20,24,25).…”

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confidence: 99%

Impaired Humoral Response to Vaccines among HIV-Exposed Uninfected Infants

Abramczuk

Mazzola

Moreno

et al. 2011

Clin. Vaccine Immunol.

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Little is known about the vaccine protective response for infants born from HIV-infected mothers. We evaluated the antibody response to hepatitis B, tetanus, and diphtheria vaccine in vertically HIV-exposed uninfected infants and compared them to those of control infants not exposed to the virus. The quantitative determination of specific neutralizing antibodies against hepatitis B, diphtheria, and tetanus were performed blindly on serum samples. The results showed that 6.7% of the HIV-exposed uninfected individuals were nonresponders to hepatitis B vaccine (anti-HBs titer, <10 mIU/ml), and 64.4% were very good responders (anti-HBs titer, >1,000 mIU/ml), whereas only 3.6% of the nonexposed infants were nonresponders ( 2 ‫؍‬ 10.93; 1 df). The HIV-exposed uninfected infants showed protective titers for diphtheria and tetanus but lower geometric mean anti-tetanus titers compared to those of the HIV-unexposed infants. Our data point to the necessity of evaluating vaccine immune responses in these children and reinforced that alterations in lymphocyte numbers and functions reported for newborns from HIV-infected mothers interfere with the vaccine response.

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“…Prior studies on ARV treated HIV infected individuals clearly established sex differences in HIV RNA levels and CD4 cell parameters among adults but have also presented conflicting results (15,16). There is one study of 158 children receiving ART that found HIV RNA levels to be 0.38 log lower in girls than in boys but found no difference in CD4 cell count or percentage (15).…”

Section: Discussionmentioning

confidence: 99%

“…There is one study of 158 children receiving ART that found HIV RNA levels to be 0.38 log lower in girls than in boys but found no difference in CD4 cell count or percentage (15). But there are few studies that analyzed differences on HIV RNA level and CD4 cell count in a large number of participants and none over such a long period of time.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in HIV-1 viral load and absolute CD4 cell count in long term survivors HIV-1 infected patients from Giurgiu, Romania

Manolescu¹,

Marinescu²

2013

Romanian Review of Laboratory Medicine

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Gender Differences in Lymphocyte Populations, Plasma HIV RNA Levels, and Disease Progression in a Cohort of Children Born to Women Infected With HIV

Cited by 24 publications

References 31 publications

Mortality in a Cohort of HIV-Infected Children: A 12-Month Outcome of Antiretroviral Therapy in Makurdi, Nigeria

Mortality in a Cohort of HIV-Infected Children: A 12-Month Outcome of Antiretroviral Therapy in Makurdi, Nigeria

Impaired Humoral Response to Vaccines among HIV-Exposed Uninfected Infants

Sex differences in HIV-1 viral load and absolute CD4 cell count in long term survivors HIV-1 infected patients from Giurgiu, Romania

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