Table 4.

Factors associated with infection and noninfection causes of death in children and adolescents who received combination antiretroviral therapy.

		Infection-related			Noninfection-related
Characteristics	Follow-up time (32 361 person-years)	Deaths, n = 214	asHR (95% CI)	P value	Deaths, n = 53	asHR (95% CI)	P value
Sex
Male	16 482	112	–		34	1.00
Female	15 879	102	–		19	0.64 (0.36–1.13)	0.125
Current age (years)^a				<0.001			0.049 0.050
<1	173	24	7.46 (4.48–12.42)	<0.001	1	0.91 (0.12–6.88)	0.925
1–4	3894	70	1.73 (1.21–2.47)	0.003	12	1.56 (0.71–3.46)	0.271
5–9	10 031	57	1.00		12	1.00
10–14	10 982	34	0.77 (0.50–1.18)	0.234	9	0.80 (0.33–1.94)	0.628
15–19	6201	24	1.36 (0.81–2.31)	0.246	16	2.79 (1.26–6.22)	0.012
20–24	1079	5	1.22 (0.45–3.36)	0.695	3	2.51 (0.62–10.24)	0.198
Current CD4⁺ cell count (cells/μl)^a				<0.001			0.033
<200	1629	124	1.00		15	1.00
200–349	1478	18	0.31 (0.18–0.53)	<0.001	6	0.84 (0.33–2.19)	0.731
350–499	7223	28	0.18 (0.11–0.29)	<0.001	11	0.47 (0.20–1.14)	0.095
≥500	17 628	11	0.05 (0.02–0.09)	<0.001	13	0.29 (0.13–0.67)	0.004
Missing	4403	33			8
Current weight-for-age z-score^a				<0.001			0.020
<−3	4327	146	1.00		22	1.00
≤−3 to <−2	6005	19	0.21 (0.13–0.34)	<0.001	9	0.56 (0.25–1.29)	0.173
≥−2	17 636	26	0.15 (0.10–0.24)	<0.001	15	0.38 (0.19–0.75)	0.005
Missing	4392	23			7
History of AIDS diagnosis^a
No	14 796	17	1.00		7	1.00
Yes	17 565	197	5.60 (3.30–9.30)	<0.001	46	4.13 (1.80–9.50)	<0.001
Currently on second-line cART^a
No	27 453	182	1.00		43	1.0
Yes	4908	32	1.64 (1.08–2.50)	0.020	10	1.21 (0.56–2.62)	0.624
Facility setting			0.212
Urban	19 909	152	1.00		30	–
Mostly urban	10 436	47	0.89 (0.64–1.23)	0.476	17	–
Mostly rural	2016	15	0.61 (0.35–1.09)	0.096	6	–
Year of first cART				<0.001			0.100
<2008	17 409	58	1.00		25	1.00
2008–1010	8898	109	1.51 (1.05–2.18)	0.028	23	1.58 (0.82–3.06)	0.171
2011–2013	4696	42	1.01 (0.66–1.55)	0.978	4	0.52 (0.17–1.60)	0.256
2014–2017	1358	5	0.27 (0.10–0.71)	0.008	1	0.37 (0.05–2.84)	0.280

Deaths due to noninfection underlying causes (n = 53) and those for which causes were unknown or not reviewed (n = 45) were competing events for deaths due to infection-related underlying causes (n = 214). Similarly, deaths due to infection-related underlying causes and those for which causes were unknown or not reviewed were competing events for deaths due to noninfection causes. 95% CI, 95% confidence interval; asHR, adjusted sub distribution hazard ratio; cART, combination antiretroviral therapy of three or more antiretrovirals.

Current age, CD4⁺ cell count, weight-for-age z-score, second-line, and AIDS were considered time-dependent variables.