Please use this identifier to cite or link to this item: http://cmuir.cmu.ac.th/jspui/handle/6653943832/56159
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dc.contributor.authorDavid C. Boettigeren_US
dc.contributor.authorLinda Aurpibulen_US
dc.contributor.authorDina Mukiarti Hudayaen_US
dc.contributor.authorSiew M. Fongen_US
dc.contributor.authorPagakrong Lumbiganonen_US
dc.contributor.authorVonthanak Saphonnen_US
dc.contributor.authorKhanh H. Truongen_US
dc.contributor.authorRawiwan Hansudewechakulen_US
dc.contributor.authorLam V. Nguyenen_US
dc.contributor.authorViet C. Doen_US
dc.contributor.authorTorsak Bunupuradahen_US
dc.contributor.authorKulkanya Chokephaibulkiten_US
dc.contributor.authorNik Khairulddin Nik Yusoffen_US
dc.contributor.authorNagalingeswaran Kumarasamyen_US
dc.contributor.authorDewi Kumara Watien_US
dc.contributor.authorKamarul Azahar Razalien_US
dc.contributor.authorAzar Kariminiaen_US
dc.contributor.authorC. V. Meanen_US
dc.contributor.authorS. Sarunen_US
dc.contributor.authorJ. Tuckeren_US
dc.contributor.authorF. J. Zhangen_US
dc.contributor.authorS. Saghayamen_US
dc.contributor.authorE. Chandrasekaranen_US
dc.contributor.authorL. P.P. Atmikasarien_US
dc.contributor.authorI. Y. Malinoen_US
dc.contributor.authorN. Kurniatien_US
dc.contributor.authorD. Muktiartien_US
dc.contributor.authorS. M. Fongen_US
dc.contributor.authorM. Thienen_US
dc.contributor.authorM. Limen_US
dc.contributor.authorF. Dauten_US
dc.contributor.authorP. Mohamaden_US
dc.contributor.authorT. J. Mohameden_US
dc.contributor.authorN. F. Abdul Rahmanen_US
dc.contributor.authorN. A.D.R. Mohammeden_US
dc.contributor.authorR. Nallusamyen_US
dc.contributor.authorK. C. Chanen_US
dc.contributor.authorT. Sudjaritruken_US
dc.contributor.authorV. Sirisanthanaen_US
dc.contributor.authorP. Oberdorferen_US
dc.contributor.authorS. Denjantaen_US
dc.contributor.authorW. Srisuken_US
dc.contributor.authorA. Kongphonoien_US
dc.contributor.authorP. Kosalaraksaen_US
dc.contributor.authorP. Tharnprisanen_US
dc.contributor.authorT. Udomphaniten_US
dc.contributor.authorG. Jourdainen_US
dc.contributor.authorT. Puthanakiten_US
dc.contributor.authorW. Prasitsuebsaien_US
dc.contributor.authorW. Chanthaweethipen_US
dc.contributor.authorK. Lapphraen_US
dc.contributor.authorW. Phongsamarten_US
dc.contributor.authorS. Sricharoenchaien_US
dc.contributor.authorQ. T. Duen_US
dc.contributor.authorC. H. Nguyenen_US
dc.contributor.authorT. M. Haen_US
dc.contributor.authorV. T. Anen_US
dc.contributor.authorK. D.T. Khuen_US
dc.contributor.authorA. N. Phamen_US
dc.contributor.authorL. T. Nguyenen_US
dc.contributor.authorO. N. Leen_US
dc.contributor.authorA. H. Sohnen_US
dc.contributor.authorN. Durieren_US
dc.contributor.authorC. Sethaputraen_US
dc.contributor.authorD. A. Cooperen_US
dc.contributor.authorM. G. Lawen_US
dc.contributor.authorA. Kariminiaen_US
dc.date.accessioned2018-09-05T03:09:49Z-
dc.date.available2018-09-05T03:09:49Z-
dc.date.issued2016-05-01en_US
dc.identifier.issn15320987en_US
dc.identifier.issn08913668en_US
dc.identifier.other2-s2.0-84964836173en_US
dc.identifier.other10.1097/INF.0000000000001074en_US
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84964836173&origin=inwarden_US
dc.identifier.urihttp://cmuir.cmu.ac.th/jspui/handle/6653943832/56159-
dc.description.abstract© Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved. Background: Information on antiretroviral therapy (ART) use in HIV-infected children with severe malnutrition (SM) is lacking. We investigated long-term ART outcomes in this population. Methods: Children enrolled in the TREAT Asia Pediatric HIV Observational Database who had SM (weight-for-height or body mass index-for-age Z score less than -3) at ART initiation were analyzed. Generalized estimating equations were used to investigate poor weight recovery (weight-for-age Z score less than -3) and poor CD4% recovery (CD4% <25), and competing risk regression was used to analyze mortality and toxicity-associated treatment modification. Results: Three hundred fifty-five (11.9%) of 2993 children starting ART had SM. Their median weight-for-age Z score increased from -5.6 at ART initiation to -2.3 after 36 months. Not using trimethoprim-sulfamethoxazole prophylaxis at baseline was associated with poor weight recovery [odds ratio: 2.49 vs. using; 95% confidence interval (CI): 1.66-3.74; P < 0.001]. Median CD4% increased from 3.0 at ART initiation to 27.2 after 36 months, and 56 (15.3%) children died during follow-up. More profound SM was associated with poor CD4% recovery (odds ratio: 1.78 for Z score less than -4.5 vs. -3.5 to less than -3.0; 95% CI: 1.08-2.92; P = 0.023) and mortality (hazard ratio: 2.57 for Z score less than -4.5 vs. -3.5 to less than -3.0; 95% CI: 1.24-5.33; P = 0.011). Twenty-two toxicity-associated ART modifications occurred at a rate of 2.4 per 100 patient-years, and rates did not differ by malnutrition severity. Conclusion: Trimethoprim-sulfamethoxazole prophylaxis is important for the recovery of weight-for-age in severely malnourished children starting ART. The extent of SM does not impede weight-for-age recovery or antiretroviral tolerability, but CD4% response is compromised in children with a very low weight-for-height/body mass index-for-age Z score, which may contribute to their high rate of mortality.en_US
dc.subjectMedicineen_US
dc.titleAntiretroviral Therapy in Severely Malnourished, HIV-infected Children in Asiaen_US
dc.typeJournalen_US
article.title.sourcetitlePediatric Infectious Disease Journalen_US
article.volume35en_US
article.stream.affiliationsUniversity of New South Wales (UNSW) Australiaen_US
article.stream.affiliationsChiang Mai Universityen_US
article.stream.affiliationsUniversity of Indonesia, RSUPN Dr. Cipto Mangunkusumoen_US
article.stream.affiliationsHospital Likasen_US
article.stream.affiliationsKhon Kaen Universityen_US
article.stream.affiliationsNational Centre for HIV/AIDS Dermatology and STDsen_US
article.stream.affiliationsChildren's Hospital 1en_US
article.stream.affiliationsChiangrai Prachanukroh Hospitalen_US
article.stream.affiliationsNational Hospital of Pediatrics Hanoien_US
article.stream.affiliationsChildren's Hospital 2en_US
article.stream.affiliationsThe HIV Netherlands Australia Thailand Research Collaborationen_US
article.stream.affiliationsMahidol Universityen_US
article.stream.affiliationsHospital Raja Perempuan Zainab IIen_US
article.stream.affiliationsVHS Medical Centre Indiaen_US
article.stream.affiliationsUniversitas Udayanaen_US
article.stream.affiliationsKuala Lumpur Hospitalen_US
article.stream.affiliationsNew Hope for Cambodian Childrenen_US
article.stream.affiliationsCapital Medical University Chinaen_US
article.stream.affiliationsPenang Hospitalen_US
article.stream.affiliationsInstitute of research for development, Thailanden_US
article.stream.affiliationsWorldwide Orphans Foundationen_US
article.stream.affiliationsTREAT Asia/amfAR-The Foundation for AIDS Researchen_US
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