ABSTRACT
Objectives: To assess the survival probability and associatedfactors among children living with human immunodeficiency virus(CLHIV) receiving antiretroviral therapy (ART) in India.Methods: The data on 5874 children (55% boys) from one of thehigh HIV burden states of India from the cohort were analyzed.Data were extracted from the computerized managementinformation system of the National AIDS Control Organization(NACO). Children were eligible for inclusion if they had startedART during 2007-2013, and had at least one potential follow-up.Kaplan Meier survival and Cox proportional hazards models wereused to measure survival probability.Results: The baseline median (IQR) CD4 count at the start ofantiretroviral therapy was 244 (153, 398). Overall, the mortalitywas 30 per 1000 child years; 39 in the <5 year age group and 25 in5-9 year age group. Mortality was highest among infants (86 per1000 child years). Those with CD4 count ?200 were six timesmore likely to die (adjusted HR: 6.3, 95% CI 3.5, 11.4) ascompared to those with a CD4 count of ?350/mm3.Conclusion: Mortality rates among CLHIV is significantly higheramong children less than five years when the CD4 count at thestart of ART is above 200. Additionally, lower CD4 count, HIVclinical staging IV, and lack of functional status seems to beassociated with high mortality in children who are on ART
ABSTRACT
Objectives: Chronic hepatitis C [CHC] is a leading cause of liver cirrhosis and hepatocellular carcinoma [HCC] worldwide. However, there is a lack of data regarding the epidemiology of CHC in Oman. This study aimed to describe the clinicopathological characteristics and outcomes of CHC-infected patients at a tertiary care hospital in Oman
Methods: This retrospective descriptive hospital-based study included all CHC-infected patients who presented to the Sultan Qaboos University Hospital [SQUH] in Muscat, Oman, between January 2010 and December 2015. The baseline demographic, clinical, laboratory and radiological data of the patients were analysed
Results: A total of 603 CHC-infected patients were identified during the study period; of these, 65.8% were male and the mean age was 44.8 +/- 16.5 years. The main risk factors associated with CHC infection were intravenous drug abuse [23.9%] and a history of blood transfusions [20.7%]. The most prevalent virus genotypes were 1 and 3 [44.0% and 35.1%, respectively]. Upon initial presentation, 33.0% of the cohort had liver cirrhosis; of these, 48.7% had decompensated cirrhosis and 23.1% had HCCs. Liver transplantation was only performed for 7.5% of the cirrhosis patients, mostly as a curative treatment for HCC
Conclusion: The implementation of national policies to prevent hepatitis C transmission and encourage the early screening of at-risk patients is recommended to reduce the burden and consequences of this disease in Oman