Table 3.
Predictors of virological rebound among cART naïve HIV infected children who achieved virological suppression while on first line antiretroviral therapy (n = 94).
| Variable | Rebound | P Value | HR (95% CI) | aHR (95%CI) | P Value | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Age in years: median (Q1–Q3) |
7 (5–13) | 9 (7–12) | 0.12 | 0.9 (0.8–1.0) | 0.9 (0.8–1.1) | 0.45 |
| Sex: N (%) Male Female |
21 (58.3) 15 (41.7) |
36 (62.1) 22 (37.9) |
Ref 0.67 |
Ref 1.2 (0.6–2.2) |
||
| PDR: N (%) Yes No |
2 (18.2) 9 (81.8) |
1 (3.3) 29 (96.7) |
Ref 0.26 |
Ref 0.4 (0.1–1.9) |
||
| TB: N (%) Yes No |
32 (88.9) 4 (11.1) |
48 (84.2) 9 (15.8) |
Ref 0.93 |
Ref 1.0 (0.3–2.7) |
||
| IPT: N (%) Yes No |
9 (25) 27 (75) |
20 (34.5) 38 (65.5) |
Ref 0.18 |
Ref 1.7 (0.8–3.6) |
Ref 2.2 (0.6–7.2) |
Ref 0.22 |
| CPT: N (%) Yes No |
22(75.9) 7 (24.1) |
43 (86) 7 (14.0) |
Ref 0.04 |
Ref 0.4 (0.2–0.9) |
Ref 1.1 (0.2–4.2) |
Ref 0.94 |
| HCT in %: median (Q1–Q3) | 37.4 (32.9–41.2) | 37.8 (35.9–40.9) | 0.75 | 1.0 (0.9–1.1) | ||
| CD4 cells/mm3 median (Q1–Q3) | 447 (223–744) | 330 (161–741) | 0.85 | 1.0 (1.0–1.0) | ||
| AST in units/dL: median (Q1–Q3) | 37 (33-–54) | 37 (29–45) | 0.50 | 1.0 (1.0–1.0) | ||
| ALT in units/dL: median (Q1–Q3) | 27 (17–38) | 25 (20–34) | 0.37 | 1.0 (1.0–1.0) | ||
| Bil-T in mg/dL: median (Q1–Q3) | 0.8 (0.4–1) | 0.6 (0.4–1.1) | 0.78 | 0.9 (0.5–1.6) | ||
| ALB in mg/dL: median (Q1–Q3) | 3.8 (3–4.3) | 3.8 (3.3–4.2) | 0.83 | 1.0 (0.6–1.4) | ||
| BUN in mg/dL: median (Q1–Q3) | 18 (12–24) | 15.3 (12–25) | 0.51 | 1.0 (0.9–1.0) | ||
| Cr in mg/dL: median (Q1–Q3) | 0.5 (0.4–0.6) | 0.6 (0.5–0.8) | 0.36 | 0.6 (0.2–1.9) | ||
| TChol in mg/dL: median (Q1–Q3) | 108 (89–142) | 128 (99–155) | 0.09 | 1.0 (1.0–1.0) | 1.0 (0.9–1.0) | 0.33 |
| cART Regimen, N (%) ABC AZT TDF |
15 (41.7) 5 (13.9) 16 (44.4) |
19 (32.8) 8 (13.8) 31 (53.5) |
Ref 0.25 0.027 |
Ref 0.5 (0.2–1.5) 0.4 (0.2–0.9) |
Ref 1.0 (0.2–4.2) 1.1 (0.3–4.1) |
Ref 0.96 0.88 |
| WHO Stage, N (%) 1 2 3 4 |
18 (51.4) 6 (17.1) 8 (22.7) 3 (8.6) |
20 (34.5) 15 (25.9) 21 (36.2) 2 (3.5) |
Ref 0.46 0.37 0.036 |
Ref 0.7 (0.3–1.8) 0.7 (0.3–1.6) 4.0 (1.1–14.3) |
Ref 0.4 (0.1–1.6) 0.6 (0.2–1.8) 3.6 (0.7–18.8) |
Ref 0.22 0.38 0.13 |
| LDL in mg/dL: median (Q1–Q3) | 45 (25–65) | 45 (32–63) | 0.90 | 1.0 (0.9–1.0) | ||
| HDL in mg/dL: median (Q1–Q3) | 48 (35–64) | 47 (38–65.2) | 0.66 | 1.0 (1.0–1.0) | ||
| TG in mg/dL: median (Q1–Q3) | 103 (89–163) | 106 (92–152) | 0.24 | 1.0 (1.0–1.0) | ||
| WAZ in ZS: median (Q1–Q3) | −1 (−1.9–(−0.1)) | −1.2 (−2.4–(−0.6)) | 0.36 | 1.1 (1.1–1.2) | ||
| HAZ in ZS: median (Q1–Q3) | −1.3 (−2.1–(−0.5)) | −1.5 (−2.5–(−0.6)) | 0.40 | 1.1 (1.0–1.1) | ||
| BAZ in ZS: median (Q1–Q3) | −0.8 (−1.9–(−0.1)) | −1.2 (−2.2–(−0.1)) | 0.49 | 1.2 (1.0–1.5) | ||
| Log10pVL: median (Q1–Q3) | 4.1 (3.0–5.0) | 4.2 (3.3–4.8) | 0.93 | 0.9 (0.6–1.2) | ||
PDR—pretreatment drug resistance; TB—Tuberculosis, all forms; IPT - isoniazid preventive therapy; CPT—co-trimoxazole preventive therapy; HCT—hematocrit; AST—aspartate transferase; ALT—alanine aminotransferase; Bil-T—total bilirubin; ALB—serum albumin; BUN—blood urea nitrogen; LDL—low density lipoprotein; TG—triglyceride; WAZ—weight-for-age Z score; BAZ—body mass index-for-age Z score; Log10 pVL—baseline viral load (after log transformation); cART—combination antiretroviral therapy; HR—Hazard ratio; aHR—adjusted hazard ratio. ** To avoid collinearity, BAZ (which is a function of weight and height) was excluded from the multivariate model. The following categories were treated as binary variables where “yes” is the reference group—PDR, TB, IPT and CPT. The reference groups for categorical variables are indicated on the table. The following were continuous variables, where hazards were defined in terms of unit decrement—age, AST, ALT, Albumin, BUN, Creatinine, bilirubin and baseline viral load. The following were continuous variables, where hazards were defined in terms of unit increment—CD4 count, hematocrit, total cholesterol, LDL, HDL, TG, WAZ, HAZ and BAZ.