Background Malnutrition is a common condition in HIV-infected children; however, its impact in survival of HIV infected children after initiation of antiretroviral therapy is not well understood.
Objective To assess the impact of malnutrition in survival of HIV infected children after initiation of antiretroviral treatment (ART).
Methods A retrospective cohort study was conducted in HIV infected children starting ART at Zewditu memorial hospital, Addis Ababa, Ethiopia. Demographic, nutritional, clinical and immunological data were carefully extracted from the existing ART logbook. Data were analysed for uinvariate and multivariate analysis using Cox regression proportional hazard model. Survival rate was calculated and compare with the Kaplan–Meier and log rank tests.
Results A total of 475 HIV infected children starting ART from 21 March 2005 to 30 April 2008 were included in the study. Of whom 42 (8.8%) died during a median study follow-up of 12 months. The average survival time for the entire cohort was 27.9 months. Independent baseline predictors of mortality were severe wasting (HR 4.99, 95% CI 2.4 to 10.2, p<0.00), absolute CD4 below the threshold for severe immunodeficiency (HR 3.02, 95% CI 1.02 to 8.96, p =0.04) and low haemoglobin value (HR 2.92, 95% CI 1.3 to 6.7, p=0.001 for those haemoglobin value <7.0 gm/dl).
Conclusion Despite the apparent benefit of ART use on HIV related survival, severe wasting (WHZ<−3) appear to be strong independent predictor of survival in HIV infected children receiving ART.
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