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Reduced Time to Suppression Among Neonates With HIV Initiating Antiretroviral Therapy Within 7 Days After Birth.
- Source :
-
JAIDS: Journal of Acquired Immune Deficiency Syndromes . 12/15/2019, Vol. 82 Issue 5, p483-490. 8p. - Publication Year :
- 2019
-
Abstract
- There are limited data on infants with HIV starting antiretroviral therapy (ART) in the neonatal period. We investigated the association between the timing of ART initiation and time-to-suppression among infants who tested HIV-positive and initiated ART within the first 28 days of life. The effect was estimated using cumulative probability flexible parametric spline models and a multivariable generalized additive mixed model was performed to test nonlinear associations. Forty-four neonates were included. Nineteen (43.2%) initiated ART within 7 days of life and 25 (56.8%) from 8 to 28 days. Infants treated within 7 days were 4-fold more likely to suppress earlier than those treated after 7 days [Hazard ratio (HR) 4.01 (1.7-9.5)]. For each week the ART initiation was delayed, the probability of suppression decreased by 35% (HR 0.65 [0.46-0.92]). Age at ART start was linearly associated with time-to-suppression. However, a linear association with normally distributed residuals was not found between baseline viral load and time-to-suppression, with no association found when baseline viral loads were ≤5 log(10) copies/mL, but with exponential increase in time-to-suppression with > log5 copies/mL at baseline. Starting ART within 7 days of life led to 4-fold faster time to viral suppression, in comparison to initiation from 8 to 28 days. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 15254135
- Volume :
- 82
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- JAIDS: Journal of Acquired Immune Deficiency Syndromes
- Publication Type :
- Academic Journal
- Accession number :
- 143826592
- Full Text :
- https://doi.org/10.1097/qai.0000000000002188