Clinical risk factors on survival among infected children born to HIV-positive mothers

Objective: The aim of this study was to investigate clinical risk factors on survival among infected children born to HIV-positive mothers in the southern region of Thailand. Methods: Data from routine prospective cohort studies from 1990–2010 were analyzed. In these studies, totally 1549 infected children born to HIV-positive mothers were enrolled at birth and followed longitudinally. Information on demographic, clinical manifestation, HIV infection status factors was collected. Survival analysis was used to determine risk factors associated with mortality. Results: The main result found that one-quarter of infected children died (434, 28.02%) during the follow-up period. A total of 135,295 person-months of follow up was available. The incident rate was 1.03 times per 100 person-months (95% CI: 0.97 to 1.08). The median survival time among infected children born to HIV-positive mothers from diagnosis to death was 87.34 months (95% CI: 87.32 to 87.36). Infected children born to HIV-infected mothers were diagnosed to confirm as AIDS (88.44%) and symptomatic HIV positive (11.56%), respectively. Regarding the clinical risk factor on survival among infected children born to HIV-positive mothers were found. Infected children born to HIV-positive mothers were more likely to die, who 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 carinii (HR: 1.50, 95% CI: 1.27 to 1.76), those compared to infected children without clinical manifestation. Conclusion: Mortality among infected children born to HIV-positive mothers contributed to high levels in the southern region of Thailand. Consequently, health service system related to prevent mother-to-child HIV transmission is needed to improve child survival by lowering HIV infection and mortality in children born to HIV-positive mothers

Clinical manifestations and survival of HIV/AIDS-infected patients, southern region of Thailand

Objective: The purpose of this study was to determine magnitude of clinical manifestations on survival of HIV/AIDS patients. Methods: The HIV/AIDS information system, a database containing demographic factors and clinical manifestations was used. A prospective, hospital-based cohort study was conducted in HIV/AIDS patients registered in both provincial and community hospitals from 14 provinces in southern region of Thailand, between January 1993 and April 2010. Totally, 52,459 of HIV/AIDS patients were routinely observed and followed up. One-fifth of the HIV/AIDS patients died (n=11,767, 22.43%) during the follow-up period. The outcome was timed from diagnosis of HIV/AIDS infection to death. Cox's proportional hazard model was used to analyze the magnitude of clinical manifestations on survival of HIV/AIDS patients. Results: A statistically significant corresponding risk of clinical manifestation on death was found. HIV/AIDS patients who had clinical manifestations including: invasive cervical cancer (HR=0.14, 95% CI: 0.44 to 0.43), herpes simplex (0.81, 0.66 to 0.98), histoplasmosis (0.67, 0.46 to 0.97), Mycobacterium other species (0.78, 0.64 to 0.97) were more likely to have a longer life. However, patients expressed clinical manifestations including; candidiasis (1.45, 1.34 to 1.56), cryptococcosis (1.77, 1.64 to 1.91), cytomegalovirus retinitis (1.58, 1.26 to 1.98), HIV encephalopathy (2.17, 1.92 to 2.47), Mycobacterium avium complex (1.76, 1.32 to 2.33) Mycobacterium tuberculosis (1.25, 1.21 to 1.30), pneumonia recurrent (1.78, 1.61 to 1.96), Pneumocystis carinii (1.71, 1.63 to 1.78), salmonella septicemia (1.85, 1.43 to 2.39) toxoplasmosis (1.47, 1.30 to 1.66) and wasting syndrome (2.13, 2.04 to 2.21) were more likely to die faster. Conclusion: In conclusion, HIV/AIDS patients expressed clinical manifestations which were a risk of death must be monitored closely and intensively care to extend their life and increase their quality of life