Survival of Children Living with HIV/AIDS: A Multicentric Study from India

With the availability of free anti-retroviral therapy (ART) for children at government ART centres in India, it is the need of the hour to assess the outcome of children who have good adherence to ART. This study was aimed at assessing their survival and outcomes. This was an ambi-spective multicentric cohort study involving three sites in India–Delhi, Pune and Kolkata. Children (less than 18 years of age) who were already enrolled on ART were recruited and followed up for a total duration of 36 months. Their baseline demographic data were collected, and blood investigations were done at baseline and at 6-monthly follow-up. A composite outcome which implied either mortality or CD4 counts less than 350 cells/mm3 at the end of follow-up was used for analysis by logistic regression. A total of 343 children were enrolled. Among the 343 patients, 5 patients were lost to follow-up, 1 opted out, and 337 patients remained in follow-up till the end of the study period. Three deaths occurred during follow-up. CD4 counts less than 350/mm3 at baseline and at multiple follow-up visits were associated with the composite outcome (P < 0.05). Among the demographic variables, a history of blood transfusion as a risk factor for HIV acquisition was associated with the composite outcome (uOR − 9.66 [2.71–34.42], P < 0.001). No other variable was significantly and consistently associated with the outcome. Low CD4 counts at baseline and during follow-up are associated with poor outcomes in children living with HIV/AIDS.