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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Net survival of perinatally and postnatally HIV-infected children: A pooled analysis of individual data from sub-Saharan Africa
International Journal of Epidemiology, Volume 40, No. 2, Year 2011
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Description
Background: Previously, HIV epidemic models have used a double Weibull curve to represent high initial and late mortality of HIV-infected children, without distinguishing timing of infection (peri- or post-natally). With more data on timing of infection, which may be associated with disease progression, a separate representation of children infected early and late was proposed. Methods: Paediatric survival post-HIV infection without anti-retroviral treatment was calculated using pooled data from 12 studies with known timing of HIV infection. Children were grouped into perinatally or post-natally infected. Net mortality was calculated using cause-deleted life tables to give survival as if HIV was the only competing cause of death. To extend the curve beyond the available data, children surviving beyond 2.5 years post infection were assumed to have the same survival as young adults. Double Weibull curves were fitted to both extended survival curves to represent survival of children infected perinatally or through breastfeeding. Results: Those children infected perinatally had a much higher risk of dying than those infected through breastfeeding, even allowing for background mortality. The final-fitted double Weibull curves gave 75% survival at 5 months after infection for perinatally infected, and 1.1 years for post-natally infected children. An estimated 25% of the early infected children would still be alive at 10.6 years compared with 16.9 years for those infected through breastfeeding. Conclusions: The increase in available data has enabled separation of child mortality patterns by timing of infection allowing improvement and more flexibility in modelling of paediatric HIV infection and survival. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2010; all rights reserved.
Authors & Co-Authors
Marston, Milly
Unknown Affiliation
Becquet, Renaud
Unknown Affiliation
Zaba, Basia W.
Unknown Affiliation
Moulton, Lawrence H.
Unknown Affiliation
Gray, Glenda E.
Unknown Affiliation
Coovadia, Hoosen Mahomed
Unknown Affiliation
Essex, Max E.
Unknown Affiliation
Ékouévi, Didier Koumavi
Unknown Affiliation
Jackson, Debra J.
Unknown Affiliation
Coutsoudis, Anna
Unknown Affiliation
Kilewo, Charles D.S.
Unknown Affiliation
Leroy, Valeriane
Unknown Affiliation
Wiktor, Stefan Zbyszko
Unknown Affiliation
Nduati, Ruth W.
Unknown Affiliation
Msellati, Philippe
Unknown Affiliation
Dabis, Franćois Ç.Ois
Unknown Affiliation
Newell, Marie Louise
Unknown Affiliation
Ghys, Peter Denis
Unknown Affiliation
Statistics
Citations: 162
Authors: 18
Affiliations: 27
Identifiers
Doi:
10.1093/ije/dyq255
ISSN:
03005771
e-ISSN:
14643685
Research Areas
Infectious Diseases
Maternal And Child Health