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Updated: May 28, 2026
13:58
Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
Published on: September 26, 2011
Mortality trends in the US Perinatal AIDS Collaborative Transmission Study (1986-2004)
Bill G Kapogiannis1, Minn M Soe, Steven R Nesheim
1Pediatric, Adolescent and Maternal AIDS Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd., Bethesda, MD 20892-7510, USA. kapogiannisb@mail.nih.gov
Summary
Highly active antiretroviral therapy (HAART) significantly reduced mortality in HIV-infected children. Survival rates improved dramatically across treatment eras, with HAART leading to a 94% 6-year survival probability for early recipients.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Epidemiology
Background:
- Highly active antiretroviral therapy (HAART) has transformed outcomes for HIV-infected individuals.
- Evaluating the long-term impact of HAART on pediatric HIV mortality is crucial due to bimodal mortality patterns.
Purpose of the Study:
- To assess the temporal trends in mortality and survival among a prospective birth cohort of HIV-infected children.
- To evaluate the specific impact of HAART on reducing mortality and improving survival rates.
Main Methods:
- Prospective, multicenter birth cohort study (PACTS/HOPE) of HIV-exposed and infected infants (1985-2004).
- Mortality analysis stratified by treatment eras: no/monotherapy, mono-/dual-therapy, and HAART.
- Survival rates and mortality rates were calculated and compared across eras.
Main Results:
- Annual mortality rates decreased significantly from 18 to 0.8 deaths per 100 person-years from the no/monotherapy to the HAART era.
- 6-year survival rates improved from 57% to 91% across the eras; HAART recipients had a 94% 6-year survival probability.
- HAART was associated with a significant reduction in mortality (HR, 0.3; 95% CI, .08-.76), with opportunistic infections accounting for fewer deaths over time.
Conclusions:
- HAART implementation led to a significant decrease in annual mortality and a substantial prolongation of survival in US perinatal HIV-infected children.
- While OI-related deaths decreased, non-OI-associated deaths became proportionally more prominent.
- The findings underscore the profound positive impact of HAART on pediatric HIV outcomes.
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