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Early neurodevelopmental markers predictive of mortality in infants infected with HIV-1

Published online by Cambridge University Press:  10 January 2003

Antolin Llorente ,
Pim Brouwers ,
Manhattan Charurat ,
Laurence Magder ,
Kathleen Malee ,
Claude Mellins ,
Janice Ware ,
Joan Hittleman ,
Lynne Mofenson  and
Jesus Velez-Borras
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Antolin Llorente
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Pim Brouwers
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Manhattan Charurat
Affiliation:
Institute of Human Virology, Baltimore, MD, USA.
Laurence Magder
Affiliation:
Institute of Human Virology, Baltimore, MD, USA.
Kathleen Malee
Affiliation:
Children's Memorial Hospital, Chicago, IL, USA.
Claude Mellins
Affiliation:
Columbia College of Physicians and Surgeons, New York City, NY, USA.
Janice Ware
Affiliation:
Department of Pediatrics, Division of Infectious Diseases, Harvard Medical School, Boston, MA, USA.
Joan Hittleman
Affiliation:
State University of New York (SUNY), NY, USA.
Lynne Mofenson
Affiliation:
NIH/National Institute of Child Health and Human Development (NICHD), Bethesda, MD, USA.
Jesus Velez-Borras
Affiliation:
Department of Pediatrics, University of Puerto Rico, San Juan, Puerto Rico, USA.
Samuel Adeniyi-Jones
Affiliation:
National Institute of Allergy and Infectious Diseases (NIAID), Bethesda, MD, USA.
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Abstract

One-hundred and fifty-seven vertically infected HIV-1 positive infants (85 males, 72 females) underwent longitudinal assessment to determine whether early neurodevelopmental markers are useful predictors of mortality in those infants who survive to at least 4 months of age. Survival analysis methods were used to estimate time to death for quartiles of 4-month scores (baseline) on the Bayley Scales of Infant Development (BSID). Cox proportional hazards progression was used to estimate relative hazard (RH, 95% CI) of death for BSID scores and potential confounders. Thirty infants with BSID scores at 4 months of age died during follow-up. Survival analysis revealed greater mortality rates in infants with BSID (Mental Developmental Index and Psychomotor Developmental Index) scores in the lower quartile(p=0.004, p=0.036). Unadjusted univariate analyses revealed increased mortality associated with baseline CD4+ 29%, gestational age <37 weeks, smaller head circumference, advanced HIV and higher plasma viral load. BSID scores independently predicted mortality after adjusting for treatment, clinical category, gestational age, plasma viral load and CD4+ percentage.

Type
Original Articles
Information
Developmental Medicine and Child Neurology , Volume 45 , Issue 2 , February 2003 , pp. 76 - 84
Copyright
© 2003 Mac Keith Press

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