Severe Recurrent Bacterial Pneumonia Among Children Living With HIV.
Pediatr Infect Dis J
; 41(5): e208-e215, 2022 05 01.
Article
em En
| MEDLINE
| ID: mdl-35185140
ABSTRACT
BACKGROUND:
Bacterial pneumonia imparts a major morbidity and mortality burden on children living with HIV, yet effective prevention and treatment options are underutilized. We explored clinical factors associated with severe recurrent bacterial pneumonia among children living with HIV.METHODS:
Children enrolled in the TREAT Asia Pediatric HIV Observational Database were included if they started antiretroviral therapy (ART) on or after January 1st, 2008. Factors associated with severe recurrent bacterial pneumonia were assessed using competing-risk regression.RESULTS:
A total of 3,944 children were included in the analysis; 136 cases of severe recurrent bacterial pneumonia were reported at a rate of 6.5 [95% confidence interval (CI) 5.5-7.7] events per 1,000 patient-years. Clinical factors associated with severe recurrent bacterial pneumonia were younger age [adjusted subdistribution hazard ratio (aHR) 4.4 for <5 years versus ≥10 years, 95% CI 2.2-8.4, P < 0.001], lower weight-for-age z-score (aHR 1.5 for <-3.0 versus >-2.0, 95% CI 1.1-2.3, P = 0.024), pre-ART diagnosis of severe recurrent bacterial pneumonia (aHR 4.0 versus no pre-ART diagnosis, 95% CI 2.7-5.8, P < 0.001), past diagnosis of symptomatic lymphoid interstitial pneumonitis or chronic HIV-associated lung disease, including bronchiectasis (aHR 4.8 versus no past diagnosis, 95% CI 2.8-8.4, P < 0.001), low CD4% (aHR 3.5 for <10% versus ≥25%, 95% CI 1.9-6.4, P < 0.001) and detectable HIV viral load (aHR 2.6 versus undetectable, 95% CI 1.2-5.9, P = 0.018).CONCLUSIONS:
Children <10-years-old and those with low weight-for-age, a history of respiratory illness, low CD4% or poorly controlled HIV are likely to gain the greatest benefit from targeted prevention and treatment programs to reduce the burden of bacterial pneumonia in children living with HIV.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Pneumonia Bacteriana
/
Fármacos Anti-HIV
Limite:
Child
/
Humans
Idioma:
En
Revista:
Pediatr Infect Dis J
Assunto da revista:
DOENCAS TRANSMISSIVEIS
/
PEDIATRIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Austrália