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Predicting Patterns of Long-Term CD4 Reconstitution in HIV-Infected Children Starting Antiretroviral Therapy in Sub-Saharan Africa: A Cohort-Based Modelling Study

Picat, MQ; Lewis, J; Musiime, V; Prendergast, A; Nathoo, K; Kekitiinwa, A; Nahirya Ntege, P; ... ARROW Trial Team, The; + view all (2013) Predicting Patterns of Long-Term CD4 Reconstitution in HIV-Infected Children Starting Antiretroviral Therapy in Sub-Saharan Africa: A Cohort-Based Modelling Study. PLoS Med , 10 (10) , Article e1001542. 10.1371/journal.pmed.1001542. Green open access

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[thumbnail of TIFF Figure 1. An illustrative representation of the mathematical model used to describe CD4 reconstitution.]
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[thumbnail of TIFF Figure 2. Modelling CD4-for-age in children showing asymptotic reconstitution]
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[thumbnail of TIFF Table 1. Characteristics at ART initiation of the two groups of HIV-infected ART-naïve children in the ARROW trial with qualitatively different CD4 reconstitution profiles]
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[thumbnail of TIFF Table 2. Predictors of CD4-for-age after ART for 914 children with asymptotic CD4 reconstitution.]
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[thumbnail of TIFF Figure 3. Predicted long-term CD4 counts in children starting ART at different ages and CD4 levels.]
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[thumbnail of TIFF Figure 4. CD4-for-age in children not showing asymptotic reconstitution.]
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[thumbnail of TIFF Table 3. Characteristics at ART initiation of four subgroups of HIV-infected ART-naïve children who did not show asymptotic CD4-for-age reconstitution on long-term ART (n = 292)]
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[thumbnail of Table S2 Additional predictors of CD4-for-age profiles in the asymptotic recovery group] MS Word (Table S2 Additional predictors of CD4-for-age profiles in the asymptotic recovery group)
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[thumbnail of Figure S1 Relationship between very low CD4 count and CD4-for-age z-score in children of different ages.]
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[thumbnail of Table S1 Univariate comparisons between individual non-asymptotic response subgroups and the large (n = 914) group of asymptotic responders] MS Word (Table S1 Univariate comparisons between individual non-asymptotic response subgroups and the large (n = 914) group of asymptotic responders)
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Abstract

Long-term immune reconstitution on antiretroviral therapy (ART) has important implications for HIV-infected children, who increasingly survive into adulthood. Children's response to ART differs from adults', and better descriptive and predictive models of reconstitution are needed to guide policy and direct research. We present statistical models characterising, qualitatively and quantitatively, patterns of long-term CD4 recovery.

Type: Article
Title: Predicting Patterns of Long-Term CD4 Reconstitution in HIV-Infected Children Starting Antiretroviral Therapy in Sub-Saharan Africa: A Cohort-Based Modelling Study
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pmed.1001542
Publisher version: http://dx.doi.org/10.1371/journal.pmed.1001542
Language: English
Additional information: PMCID: PMC3812080 © 2013 Picat et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1373456
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