Clinical Risk Factors on Survival among HIV-Infected Children Born to HIV-Infected Mothers
Bhunyabhadh Chaimay PhD*, Somkiattiyos Woradet PhD*, Sawanya Chantutanon PhD**, Supparaporn Phuntara MSc**, Kannika Suwanna MSc***
Affiliation : * Faculty of Health and Sports Science, Thaksin University, Phatthalung Campus, Phatthalung, Thailand ** Center for Diseases Control and Prevention Region 12, Songkhla, Thailand *** Center for Diseases Control and Prevention Region 11, Nakhon Si Thammarat, Thailand
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
