Mouhari-Touré A, Mahamadou G, Kombate K, Akakpo A S, Teclessou J N, Singo A, Pitché P
Service de dermatologie et IST, CHU Kara, Togo.
Service de dermatologie, CHU Syvanus Olympio, Lomé, Lomé, Togo.
Med Sante Trop. 2018 Feb 1;28(1):54-60. doi: 10.1684/mst.2018.0767.
the aim of this study was to evaluate the mortality and morbidity of HIV-infected children on highly active antiretroviral treatment (HAART) in Togo. this is a retrospective study of HIV-infected children on HAART in the 25 largest centers of HIV/AIDS care in Togo. the study included 1861 children (sex-ratio=0.99). Among them, 35.6 % were in WHO clinical stages 3 or 4 at the beginning of HAART. The most common opportunistic infections were coughing and pneumonia (37.1 %), gastroenteritis (11.3 %), various bacterial infections (10.4 %), and pruritus (10.4 %). The incidence of death was estimated at 4.5 per 100 person-years. Mortality was highest during the first year of antiretroviral therapy. The survival rate at 12 months of ART was 92.6 %. Children who began HAART at WHO clinical stage 4 had a significantly lower survival rate than the others (P<0.0001). The presence of a side effect of HAART (P=0.041), and hospitalization (P<0.001) were significantly associated with death in these children. although the new recommendations for medical care require early initiation of HAART, the improved performance of programs to prevent maternal-infant transmission remains crucial in reducing morbidity and mortality of children on HAART in Togo.
本研究旨在评估多哥接受高效抗逆转录病毒治疗（HAART）的HIV感染儿童的死亡率和发病率。这是一项对多哥25个最大的HIV/AIDS护理中心接受HAART的HIV感染儿童进行的回顾性研究。该研究纳入了1861名儿童（性别比=0.99）。其中，35.6%的儿童在开始HAART时处于世界卫生组织临床3期或4期。最常见的机会性感染是咳嗽和肺炎（37.1%）、肠胃炎（11.3%）、各种细菌感染（10.4%）和瘙痒（10.4%）。死亡发生率估计为每100人年4.5例。抗逆转录病毒治疗的第一年死亡率最高。抗病毒治疗12个月时的生存率为92.6%。在世界卫生组织临床4期开始HAART的儿童的生存率明显低于其他儿童（P<0.0001）。HAART的副作用（P=0.041）和住院治疗（P<0.001）与这些儿童的死亡显著相关。尽管新的医疗护理建议要求尽早开始HAART，但提高预防母婴传播项目的成效对于降低多哥接受HAART儿童的发病率和死亡率仍然至关重要。
