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P3.04 Predictors of mortality in children under 15 years old who acquired hiv from mother to child transmission in paraguay
  1. G Aguilar1,2,3,
  2. AE Miranda2,
  3. T Samudio3,
  4. A Kawabata1,
  5. S Muñoz4,
  6. F Galeano5
  1. 1Universidad Nacional de Caaguazu, Coronel Oviedo, Paraguay
  2. 2Universidade Federal do Espirito Santo (UFES), Vitoria, Brazil
  3. 3National Program of HIV/AIDS,Asunción, Paraguay
  4. 4Universidad de la Frontera-Facultad de Medicina, Paraguay
  5. 5Temuco, Chile Instituto de Medicina Tropical, Asunción, Paraguay

Abstract

Introduction Paraguay has made efforts to improve the response to HIV infection, and it is important to assess the impact of interventions in paediatrics. To estimate predictors of mortality in children who acquired HIV from mother to child transmission, between January 2000 and December 2014.

Methods A birth cohort study among persons living with HIV infection (PLWH), they were <15 years of age at enrollment. We abstracted data from clinic records, using a standardised form; obtained the data of death from clinic records and confirmations of deaths from deaths’ certificates. We used survival analysis techniques to estimate the incidence of death.

Results A total of 302 subjects were included in the survey. 71.4% younger than six years of age, 51.0% female, 74.3% were from the metropolitan area. There were 52 deaths (17.2% of participants), resulting in an overall mortality rate of 1.86 deaths/100 person-years [95% confidence interval (CI) 1.39, 2.44]. The Children with baseline HIV viral load >1 00 000 copies/mL were four times more likely to die than children with baseline HIV viral load ≤100.000 (HR, 4.47; 95% CI: 1.79, 11.10). Regarding age-stratified staging of disease, those children with stage 3 were four times more likely to die compared with children on Stage (1 and 2) (HR: 4,19; 95% CI: 1,50,11,70). Those children with haemoglobin level ≤9 g/dL at baseline have four time more chance to die compared with haemoglobin level ≥9 g/dL (HR: 3.90; 95% CI1.61, 9.80).

Conclusion The mortality of children with HIV in Paraguay is low. High HIV viral load, late stage and moderate or severe anaemia at first diagnosis time are associated with mortality. Improving prenatal care and paediatric follow-up in an effort to diagnose vertically infected children as early as possible should be an integrated part of the healthcare provided to the child with AIDS, and it is very important an action that may increase survival in these children.

Support: University of California, San Francisco’s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, R25MH064712

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