Research Directorate General, National University of Caaguazú, Km 138 Ruta N°8 Blas A. Garay, 8, Coronel Oviedo, Paraguay.
Department of Strategic Information and Surveillance, National HIV Program, Asunción, Paraguay.
AIDS Behav. 2018 Jul;22(Suppl 1):99-104. doi: 10.1007/s10461-018-2053-1.
We estimated mortality rate and predictors of death in children and adolescents who acquired HIV through mother-to-child transmission in Paraguay. In 2000-2014, we conducted a cohort study among children and adolescents aged < 15 years. We abstracted data from medical records and death certificates. We used the Cox proportional hazards model for the multivariable analysis of mortality predictors. A total of 302 subjects were included in the survey; 216 (71.5%) were younger than 5 years, 148 (51.0%) were male, and 214 (70.9%) resided in the Asunción metropolitan area. There were 52 (17.2%) deaths, resulting in an overall mortality rate of 2.06 deaths per 100 person-years. The children and adolescents with hemoglobin levels ≤ 9 g/dL at baseline had a 2-times higher hazard of death compared with those who had levels > 9 g/dL (HR 2.27, 95% CI 1.01-5.10). The mortality of HIV-infected children and adolescents in Paraguay is high, and anemia is associated with mortality. Improving prenatal screening to find cases earlier and improving pediatric follow-up are needed.
我们评估了巴拉圭母婴传播途径感染 HIV 的儿童和青少年的死亡率和死亡预测因素。2000-2014 年,我们开展了一项年龄<15 岁的儿童和青少年队列研究。我们从病历和死亡证明中提取数据。我们使用 Cox 比例风险模型对死亡率预测因素进行多变量分析。共有 302 名调查对象,其中 216 名(71.5%)年龄小于 5 岁,148 名(51.0%)为男性,214 名(70.9%)居住在亚松森大都市区。有 52 名(17.2%)死亡,总死亡率为每 100 人年 2.06 人死亡。与血红蛋白水平>9g/dL 的儿童和青少年相比,基线时血红蛋白水平≤9g/dL 的儿童和青少年死亡的风险高 2 倍(HR 2.27,95%CI 1.01-5.10)。巴拉圭感染 HIV 的儿童和青少年死亡率较高,贫血与死亡率相关。需要改善产前筛查以更早发现病例,并改善儿科随访。