Table 2.
Virologic and immunologic response outcomes, stratified by TB treatment status
| Outcome | All patients | Children receiving TB treatment |
Children not receiving TB treatment |
P | |||
|---|---|---|---|---|---|---|---|
| Virologic suppression | |||||||
| Time to suppression, median months (IQR) | 6.2 | (3.9 – 11.5) | 6.2 | (4.6 – 11.7) | 6.2 | (3.5 – 10.7) | 0.50 |
| HR (95% CI) | |||||||
| 6 months (crude) | 1.09 | (0.67, 1.77) | 1.0 | 0.73 | |||
| 6 months (adjusted)a | 1.20 | (0.69, 2.08) | 1.0 | 0.53 | |||
| 12 months (crude) | 1.04 | (0.72, 1.49) | 1.0 | 0.85 | |||
| 12 months (adjusted)a | 1.23 | (0.82, 1.84) | 1.0 | 0.32 | |||
| 24 months (crude) | 0.94 | (0.69, 1.28) | 1.0 | 0.68 | |||
| 24 months (adjusted)a | 1.36 | (0.94, 1.96) | 1.0 | 0.10 | |||
| Virologic rebound b | |||||||
| HIV RNA >1000 copies/mL, no. (%) | 39/164 | (23.8) | 18/77 | (23.4) | 21/87 | (24.1) | 0.91 |
| Time to rebound, median months (IQR) | 18.3 | (12.2 – 23.5) | 18.3 | (15.0 – 21.0) | 17.8 | (12.0 – 23.7) | 0.89 |
| Crude HR (95% CI)c | 1.10 | (0.58, 2.08) | 1.0 | 0.77 | |||
| Adjusted HR (95% CI)a,c | 1.53 | (0.71, 3.30) | 1.0 | 0.27 | |||
| Immunologic response | |||||||
| CD4%, median (IQR) | |||||||
| cART initiation | 17.1 | (11.6 – 23.3) | 15.3 | (9.5 – 21.0) | 18.8 | (14.3 – 25.3) | <0.01 |
| 3 months | 25.5 | (19.1 – 32.3) | 22.6 | (16.7 – 29.1) | 26.5 | (20.0 – 33.7) | 0.03 |
| 6 months | 27.8 | (20.6 – 34.2) | 24.8 | (18.6 – 30.9) | 30.1 | (24.8 – 36.9) | <0.01 |
| 12 months | 29.5 | (23.6 – 34.7) | 27.3 | (21.4 – 33.2) | 30.9 | (25.0 – 36.2) | 0.04 |
| 24 months | 33.6 | (26.2 – 37.5) | 31.3 | (21.9 – 36.7) | 34.5 | (27.0 – 38.2) | 0.09 |
| Increase in CD4%, median (IQR) | |||||||
| 3 months | 7.2 | (3.3 – 11.4) | 7.2 | (3.6 – 11.0) | 6.5 | (3.3 – 11.9) | 0.90 |
| 6 months | 9.7 | (5.4 – 14.1) | 9.9 | (5.2 – 14.4) | 9.6 | (5.6 – 14.0) | 0.85 |
| 12 months | 13.3 | (7.9 – 17.5) | 14.2 | (9.2 – 18.7) | 11.9 | (7.0 – 16.3) | 0.06 |
| 24 months | 14.4 | (9.1 – 19.7) | 14.5 | (9.6 – 19.2) | 14.2 | (8.0 – 20.0) | 0.87 |
| Severe immunodeficiency, no. (%)d | |||||||
| 3 months | 57/115 | (49.6) | 31/54 | (57.4) | 26/61 | (42.6) | 0.11 |
| 6 months | 58/151 | (38.4) | 38/73 | (52.1) | 20/78 | (25.6) | <0.01 |
| 12 months | 27/116 | (23.3) | 15/48 | (31.3) | 12/68 | (17.6) | 0.09 |
| 24 months | 7/101 | (6.9) | 7/48 | (14.6) | 0/53 | (0.0) | <0.01 |
Abbreviations: cART, combination antiretroviral therapy; CD4%, CD4 cell percentage; CI, confidence interval; HR, hazard ratio; IQR, interquartile range; TB, tuberculosis.
Multivariable models adjusted for timing of cART initiation relative to the 2010 change in guidelines, age at cART initiation, sex, cART regimen, and baseline HIV RNA, CD4 cell percentage, hemoglobin, and weight-for-age z-score. Adjusted models include individuals who had complete covariate data: n=164 for the suppression models and n=139 for the rebound model.
Virologic rebound was assessed among the 164 individuals who suppressed <50 copies/mL at any point following cART initiation.
Hazard ratios account for 24 months of follow-up after cART initiation.
Severe immunodeficiency was defined according to World Health Organization age-specific classifications 21: CD4% <25% in children <11 months, CD4% <20% in children 12-35 months, CD4% <15% in children 36-59 months, and CD4 cell count <200 cells/μL or CD4% <15% in children >5 years.