Long-term risk of mortality and loss to follow-up in children and adolescents on antiretroviral therapy in Asia
9
Issued Date
2024-01-01
Resource Type
ISSN
14642662
eISSN
14681293
Scopus ID
2-s2.0-85205282337
Pubmed ID
39324422
Journal Title
HIV Medicine
Rights Holder(s)
SCOPUS
Bibliographic Citation
HIV Medicine (2024)
Suggested Citation
Nimkar S., Kinikar A., Mave V., Khol V., Du Q.T., Nguyen L., Ounchanum P., Nguyen D.Q., Puthanakit T., Kosalaraks P., Chokephaibulkit K., Sudjaritruk T., Muktiarti D., Kumarasamy N., Yusoff N.K.N., Mohamed T., Wati D., Alam A., Fong S., Nallusamy R., Suwanlerk T., Sohn A., Kariminia A., Ly P.S., Khol V., Penh P., Tucker J., Kumarasamy N., Chandrasekaran E., Kinikar A., Mave V., Nimkar S., Marbaniang I., Wati D.K., Vedaswari D., Ramajaya I.B., Ngoerah I.G.N.G., Kurniati N., Muktiarti D., Mangunkusumo C., Fong S.M., Lim M., Daut F., Yusoff N.N., Mohamad P., Mohamed T.J., Drawis M.R., Nallusamy R., Chan K.C., Sudjaritruk T., Sirisanthana V., Aurpibul L., Ounchanum P., Hansudewechakul R., Denjanta S., Kongphonoi A., Lumbiganon P., Kosalaraksa P., Tharnprisan P., Udomphanit T., Jourdain G., Puthanakit T., Anugulruengkit S., Jantarabenjakul W., Nadsasarn R., Chokephaibulkit K., Lapphra K., Phongsamart W., Sricharoenchai S., Truong K.H., Du Q.T., Nguyen C.H., Nguyen L.V., Tran D.M., Tran H.T.T., Giang T.T.T., Le O.N., Sohn A.H., Ross J.L., Suwanlerk T., Law M.G., Kariminia A. Long-term risk of mortality and loss to follow-up in children and adolescents on antiretroviral therapy in Asia. HIV Medicine (2024). doi:10.1111/hiv.13718 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/101517
Title
Long-term risk of mortality and loss to follow-up in children and adolescents on antiretroviral therapy in Asia
Author(s)
Nimkar S.
Kinikar A.
Mave V.
Khol V.
Du Q.T.
Nguyen L.
Ounchanum P.
Nguyen D.Q.
Puthanakit T.
Kosalaraks P.
Chokephaibulkit K.
Sudjaritruk T.
Muktiarti D.
Kumarasamy N.
Yusoff N.K.N.
Mohamed T.
Wati D.
Alam A.
Fong S.
Nallusamy R.
Suwanlerk T.
Sohn A.
Kariminia A.
Ly P.S.
Khol V.
Penh P.
Tucker J.
Kumarasamy N.
Chandrasekaran E.
Kinikar A.
Mave V.
Nimkar S.
Marbaniang I.
Wati D.K.
Vedaswari D.
Ramajaya I.B.
Ngoerah I.G.N.G.
Kurniati N.
Muktiarti D.
Mangunkusumo C.
Fong S.M.
Lim M.
Daut F.
Yusoff N.N.
Mohamad P.
Mohamed T.J.
Drawis M.R.
Nallusamy R.
Chan K.C.
Sudjaritruk T.
Sirisanthana V.
Aurpibul L.
Ounchanum P.
Hansudewechakul R.
Denjanta S.
Kongphonoi A.
Lumbiganon P.
Kosalaraksa P.
Tharnprisan P.
Udomphanit T.
Jourdain G.
Puthanakit T.
Anugulruengkit S.
Jantarabenjakul W.
Nadsasarn R.
Chokephaibulkit K.
Lapphra K.
Phongsamart W.
Sricharoenchai S.
Truong K.H.
Du Q.T.
Nguyen C.H.
Nguyen L.V.
Tran D.M.
Tran H.T.T.
Giang T.T.T.
Le O.N.
Sohn A.H.
Ross J.L.
Suwanlerk T.
Law M.G.
Kariminia A.
Kinikar A.
Mave V.
Khol V.
Du Q.T.
Nguyen L.
Ounchanum P.
Nguyen D.Q.
Puthanakit T.
Kosalaraks P.
Chokephaibulkit K.
Sudjaritruk T.
Muktiarti D.
Kumarasamy N.
Yusoff N.K.N.
Mohamed T.
Wati D.
Alam A.
Fong S.
Nallusamy R.
Suwanlerk T.
Sohn A.
Kariminia A.
Ly P.S.
Khol V.
Penh P.
Tucker J.
Kumarasamy N.
Chandrasekaran E.
Kinikar A.
Mave V.
Nimkar S.
Marbaniang I.
Wati D.K.
Vedaswari D.
Ramajaya I.B.
Ngoerah I.G.N.G.
Kurniati N.
Muktiarti D.
Mangunkusumo C.
Fong S.M.
Lim M.
Daut F.
Yusoff N.N.
Mohamad P.
Mohamed T.J.
Drawis M.R.
Nallusamy R.
Chan K.C.
Sudjaritruk T.
Sirisanthana V.
Aurpibul L.
Ounchanum P.
Hansudewechakul R.
Denjanta S.
Kongphonoi A.
Lumbiganon P.
Kosalaraksa P.
Tharnprisan P.
Udomphanit T.
Jourdain G.
Puthanakit T.
Anugulruengkit S.
Jantarabenjakul W.
Nadsasarn R.
Chokephaibulkit K.
Lapphra K.
Phongsamart W.
Sricharoenchai S.
Truong K.H.
Du Q.T.
Nguyen C.H.
Nguyen L.V.
Tran D.M.
Tran H.T.T.
Giang T.T.T.
Le O.N.
Sohn A.H.
Ross J.L.
Suwanlerk T.
Law M.G.
Kariminia A.
Author's Affiliation
Siriraj Hospital
VHS Medical Centre India
Vietnam National Children's Hospital
Children's Hospital No. 1 Ho Chi Minh City
Universitas Udayana
Universitas Padjadjaran
Universitas Indonesia
Faculty of Medicine, Chiang Mai University
The Kirby Institute
Faculty of Medicine, Khon Kaen University
Kuala Lumpur Hospital
Penang Adventist Hospital
Johns Hopkins University
Faculty of Medicine, Chulalongkorn University
Children's Hospital 2
National Centre for HIV/AIDS
B. J. Government Medical College and Sassoon General Hospital
Hospital Raja Perempuan Zainab II
amfAR - The Foundation for AIDS Research
Chiangrai Prachanukroh Hospital
Hospital Likas
VHS Medical Centre India
Vietnam National Children's Hospital
Children's Hospital No. 1 Ho Chi Minh City
Universitas Udayana
Universitas Padjadjaran
Universitas Indonesia
Faculty of Medicine, Chiang Mai University
The Kirby Institute
Faculty of Medicine, Khon Kaen University
Kuala Lumpur Hospital
Penang Adventist Hospital
Johns Hopkins University
Faculty of Medicine, Chulalongkorn University
Children's Hospital 2
National Centre for HIV/AIDS
B. J. Government Medical College and Sassoon General Hospital
Hospital Raja Perempuan Zainab II
amfAR - The Foundation for AIDS Research
Chiangrai Prachanukroh Hospital
Hospital Likas
Corresponding Author(s)
Other Contributor(s)
Abstract
Objective: We described mortality and loss to follow-up (LTFU) in children and adolescents who were under care for more than 5 years following initiation of antiretroviral therapy (ART). Methods: Patients were followed from 5 years after ART until the earlier of their 25th birthday, last visit, death, or LTFU. We used Cox regression to assess predictors of mortality and competing risk regression to assess factors associated with LTFU. Results: In total, 4488 children and adolescents initiating ART between 1997 and 2016 were included in the analysis, with a median follow-up time of 5.2 years. Of these, 107 (2.2%) died and 271 (6.0%) were LTFU. Mortality rate was 4.35 and LTFU rate 11.01 per 1000 person-years. Increased mortality was associated with AIDS diagnosis (adjusted hazard ratio [aHR] 1.71; 95% confidence interval [CI] 1.24–2.37), current CD4 count <350 cells/mm3 compared with ≥500 (highest aHR 13.85; 95% CI 6.91–27.76 for CD4 <200), viral load ≥10 000 copies/mL compared with <400 (aHR 3.28; 95% CI 1.90–5.63), and exposure to more than one ART regimen (aHR 1.51; 95% CI 1.14–2.00). Factors associated with LTFU were male sex (adjusted subdistribution hazard ratio [asHR] 1.29; 95% CI 1.04–1.59), current viral load >1000 copies/mL compared with <400 (highest asHR 2.36; 95% CI 1.19–4.70 for viral load 1000–9999), and ART start after year 2005 compared with ≤2005 (highest asHR 5.96; 95% CI 1.98–17.91 for 2010–2016). Conclusion: For children and adolescents surviving 5 years on ART, both current CD4 and viral load remained strong indicators that help to keep track of their treatment outcomes. More effort should be made to monitor patients who switch treatments.