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Mortality and treatment outcomes of China's National Pediatric antiretroviral therapy program

Yan Zhao1, Chunming Li, Xin Sun

  • 1National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|November 24, 2012
PubMed

Insights

China's national pediatric antiretroviral therapy (ART) program shows 94% survival after 3 years. Key risk factors for mortality include low weight-for-age z-score and advanced disease stage, highlighting the program's effectiveness and need for expansion.

Area of Science:

  • Pediatric infectious diseases
  • Public health interventions
  • HIV/AIDS clinical management

Background:

  • China's national free pediatric antiretroviral therapy (ART) program aims to improve outcomes for children with HIV.
  • Understanding 3-year mortality rates and risk factors is crucial for program optimization.

Purpose of the Study:

  • To determine 3-year mortality rates in children enrolled in China's national pediatric ART program.
  • To identify risk factors associated with mortality.
  • To assess long-term clinical outcomes, including CD4 counts and nutritional status.

Main Methods:

  • Retrospective analysis of national HIV/AIDS and pediatric ART databases.
  • Inclusion of HIV-positive children ≤15 years old who initiated ART before December 2010.
  • Cox proportional hazards regression for mortality risk factors and generalized estimating equation models for longitudinal outcomes.

Main Results:

  • Overall mortality rate of 2.31 per 100 child-years (CY) among 1818 children.
  • Significant mortality risk factors: baseline weight-for-age z-score <-2 (aHR=9.1), WHO stage III/IV disease (aHR=2.4), and hemoglobin <90 g/L (aHR=2.2).
  • Improved CD4%, hemoglobin, WAZ, and HAZ scores over 3 years of follow-up.

Conclusions:

  • China's national pediatric ART program is effective, with 94% of children surviving and showing improved health after 3 years.
  • Program expansion is recommended to meet treatment demands.
  • Prioritizing early identification of HIV-positive children is essential.
Abstract

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