Publication:
Determining standardized causes of death of infants, children, and adolescents living with HIV in Asia

Issued Date

2020-08-01

Resource Type

Article

ISSN

14735571

DOI

10.1097/QAD.0000000000002583

Other identifier(s)

2-s2.0-85088266100

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

AIDS (London, England). Vol.34, No.10 (2020), 1527-1537

Suggested Citation

Annette H. Sohn, Pagakrong Lumbiganon, Nia Kurniati, Keswadee Lapphra, Matthew Law, Viet C. Do, Lam Van Nguyen, Khanh H. Truong, Dewi K. Wati, Pradthana Ounchanum, Thanyawee Puthanakit, Tavitiya Sudjaritruk, Penh S. Ly, Nik K.N. Yusoff, Sieu M. Fong, Thahira J. Mohamed, Revathy Nallusamy, Nagalingaswaran Kumarasamy, Azar Kariminia Determining standardized causes of death of infants, children, and adolescents living with HIV in Asia. AIDS (London, England). Vol.34, No.10 (2020), 1527-1537. doi:10.1097/QAD.0000000000002583 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/57945

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Title

Determining standardized causes of death of infants, children, and adolescents living with HIV in Asia

Author(s)

Annette H. Sohn
 Pagakrong Lumbiganon
 Nia Kurniati
 Keswadee Lapphra
 Matthew Law
 Viet C. Do
 Lam Van Nguyen
 Khanh H. Truong
 Dewi K. Wati
 Pradthana Ounchanum
 Thanyawee Puthanakit
 Tavitiya Sudjaritruk
 Penh S. Ly
 Nik K.N. Yusoff
 Sieu M. Fong
 Thahira J. Mohamed
 Revathy Nallusamy
 Nagalingaswaran Kumarasamy
 Azar Kariminia

Other Contributor(s)

VHS Medical Centre India
 National Hospital of Pediatrics Hanoi
 Universitas Udayana
 University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
 Chulalongkorn University
 Kirby Institute
 Kuala Lumpur Hospital
 Khon Kaen University
 Faculty of Medicine, Siriraj Hospital, Mahidol University
 Chiang Mai University
 National Centre for HIV/AIDS
 Children's Hospital 2
 Children's Hospital 1
 amfAR - The Foundation for AIDS Research
 Chiangrai Prachanukroh Hospital
 Hospital Likas
 Hospital Raja Perempuan Zainab II
 Penang Hospital

Abstract

OBJECTIVE: To implement a standardized cause of death reporting and review process to systematically disaggregate causes of HIV-related deaths in a cohort of Asian children and adolescents. DESIGN: Death-related data were retrospectively and prospectively assessed in a longitudinal regional cohort study. METHODS: Children under routine HIV care at sites in Cambodia, India, Indonesia, Malaysia, Thailand, and Vietnam between 2008 and 2017 were followed. Causes of death were reported and then independently and centrally reviewed. Predictors were compared using competing risks survival regression analyses. RESULTS: Among 5918 children, 5523 (93%; 52% male) had ever been on combination antiretroviral therapy. Of 371 (6.3%) deaths, 312 (84%) occurred in those with a history of combination antiretroviral therapy (crude all-cause mortality 9.6 per 1000 person-years; total follow-up time 32 361 person-years). In this group, median age at death was 7.0 (2.9-13) years; median CD4 cell count was 73 (16-325) cells/μl. The most common underlying causes of death were pneumonia due to unspecified pathogens (17%), tuberculosis (16%), sepsis (8.0%), and AIDS (6.7%); 12% of causes were unknown. These clinical diagnoses were further grouped into AIDS-related infections (22%) and noninfections (5.8%), and non-AIDS-related infections (47%) and noninfections (11%); with 12% unknown, 2.2% not reviewed. Higher CD4 cell count and better weight-for-age z-score were protective against death. CONCLUSION: Our standardized cause of death assessment provides robust data to inform regional resource allocation for pediatric diagnostic evaluations and prioritization of clinical interventions, and highlight the continued importance of opportunistic and nonopportunistic infections as causes of death in our cohort.

Keyword(s)

Immunology and Microbiology
 Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/57945

Collections

Scopus 2020