J Med Assoc Thai 2013; 96 (11):1434

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Clinical Risk Factors on Survival among HIV-Infected Children Born to HIV-Infected Mothers
Chaimay B Mail, Woradet S , Chantutanon S , Phuntara S , Suwanna K

Objective: The present study was to investigate clinical risk factors of survival among HIV-infected children born from HIV-infected mothers in the Southern region of Thailand.

Material and Method: Data from routine prospective cohort studies between 1990 and 2010 were analyzed. In these studies, 1,549 HIV-infected children born to HIV-infected mothers were enrolled at birth and followed longitudinally. Information on demographic, clinical manifestations, and HIV-infection status factors was collected. Survival analysis was used to determine risk factors associated with mortality.

Results: Results found that one-fourth of HIV-infected children died (434, 28.02%) during the follow-up period. The follow-up available equals to 135,295 person-months. The incidence rate was 1.03 times per 100 person-months (95% CI: 0.97 to 1.08). The median survival time among HIV-infected children from diagnosis to death was 87.34 months (95% CI: 87.32 to 87.36). HIV-infected children were diagnosed to confirm as AIDS (88.44%) and symptomatic HIV positive (11.56%). Clinical risk factors on survival among HIV-infected children were found. HIV-infected children were more likely to die if they were infected with candidiasis (HR: 1.47, 95% CI: 1.07 to 2.00), Mycobacterium tuberculosis (HR: 1.51, 95% CI: 1.26 to 1.81), and Pneumocystis jiroveci (HR: 1.50, 95% CI: 1.27 to 1.76) as compared to HIV-infected children without clinical manifestation.

Conclusion: Mortality among infected children born to HIV-positive mothers is high in the Southern region of Thailand. Consequently, health service system related to prevent mother-to-child HIV-transmission is needed to improve child survival.

Keywords: Clinical risk factor, Survival, Infected children, HIV-positive mother

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