Reduction in mortality with availability of antiretroviral therapy for children with perinatal HIV-1 infection

Maurizio de Martino, Pier Angelo Tovo, Maria Balducci, Luisa Galli, Clara Gabiano, Giovanni Rezza, Patrizio Pezzotti, Patrizia Osimani, Cesare Di Bari, Domenico Larovere, Maurizio Ruggeri, Massimo Masi, Fernando Specchia, Laura Battisti, Marzia Duse, Paola Crispino, Paolo Carrara, Carlo Pintor, Maurizio Dedoni, Carlo DessìDaniela Loriano, Elisa Anastasio, Teresa Bezzi, Marco De Luca, Silvia Farina, Alberto Vierucci, Dante Bassetti, Emanuele Pontali, Silvia Boni, Maria Grazia Marazzi, Loredana Tasso, Chiara Giovanettoni, Filippo Salvini, Raffaella Pinzani, Paola Marchisio, Alessandra Viganò, Raffaella Tornaghi, Gian Vincenzo Zuccotti, Enrica Riva, Marcello Giovannini, Rita Lipreri, Stefania Conio, Gabriele Ferraris, Monica Cellini, Cecilia Baraldi, Alfredo Guarino, Roberto Berni Canani, Luigi Tarallo, Carlo Giaquinto, Ezia Ruga, Osvalda Rampon, Ernesto Renato Dalle Nogare, Adriana Sanfilippo, Amelia Romano, Giorgio Benaglia, Icilio Dodi, Desirèe Caselli, Anna Maccabruni, Ilaria Pacati, Rita Consolini, Gabriella Palla, Maria Teresa Cecchi, Vico Vecchi, Gianfranco Anzidei, Stefano Cerilli, Rosa Chiodi, Guido Castelli Gattinara, Andrea Krzysztofiak, Stefania Bernardi, Carlo Fundarò, Orazio Genovese, Giovanna Stefania Colafati, Salvatore Catania, Camilla Ajassa, Antonio Mazza, Sara Garetto, Caterina Riva, Carlo Scolfaro

Research output: Contribution to journalArticle

Abstract

Context. Since the introduction of combined antiretroviral therapy, mortality rates in adults with human immunodeficiency virus type 1 (HIV-1) infection have decreased. However, little information is available outside the setting of controlled trials on survival of perinatally HIV-infected children treated with antiretroviral therapy. Objective. To assess effect of availability of antiretroviral therapy on decreasing mortality in perinatally HIV-infected children. Design. Population-based, multicenter longitudinal study involving data collected by the Italian Register for HIV Infection in Children. Setting. A network of 106 pediatric clinical centers. Subjects. A total of 1142 children born between November 1980 and December 1997 with perinatally acquired HIV infection with a median follow - up of 5.9 years. Main Outcome Measure. Time to HIV-related death calculated for birth cohort and calendar period and grouped by distribution of predominant type of antiretroviral therapy administered over time. Results. Survival was longer in the 1996-1997 birth cohort (crude relative hazard [RH] of death, 0.39; 95% confidence interval [Cl], 0.15-0.96) and 1996-1998 calendar period (crude RH of death, 0.65; 95% Cl, 0.45-0.95) than in birth cohort and calendar period 1980-1995, but not when adjusted for maternal antiretroviral treatment during pregnancy and clinical condition at time of delivery, gestational age, and birth weight (adjusted RH of death, 0.55; 95% Cl, 0.20-1.50, for birth cohort; and adjusted RH of death, 0.71, 95% Cl, 0.43-1.16, for calendar period). In a multivariate model with 1980-1995 as comparison, the 1996-1997 birth cohort had an RH of 0.57 (95% Cl, 0.22-1.47; P=27) but RH for calendar period 1996-1998 was 0.63 (95% Cl, 0.47-0.85; P

Original languageEnglish
Pages (from-to)190-197
Number of pages8
JournalJournal of the American Medical Association
Volume284
Issue number2
Publication statusPublished - Jul 12 2000

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Virus Diseases
HIV-1
Parturition
Mortality
HIV
HIV Infections
Therapeutics
Birth Weight
Gestational Age
Multicenter Studies
Longitudinal Studies
Mothers
Outcome Assessment (Health Care)
Calendars
Confidence Intervals
Pediatrics
Pregnancy
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

de Martino, M., Tovo, P. A., Balducci, M., Galli, L., Gabiano, C., Rezza, G., ... Scolfaro, C. (2000). Reduction in mortality with availability of antiretroviral therapy for children with perinatal HIV-1 infection. Journal of the American Medical Association, 284(2), 190-197.

Reduction in mortality with availability of antiretroviral therapy for children with perinatal HIV-1 infection. / de Martino, Maurizio; Tovo, Pier Angelo; Balducci, Maria; Galli, Luisa; Gabiano, Clara; Rezza, Giovanni; Pezzotti, Patrizio; Osimani, Patrizia; Di Bari, Cesare; Larovere, Domenico; Ruggeri, Maurizio; Masi, Massimo; Specchia, Fernando; Battisti, Laura; Duse, Marzia; Crispino, Paola; Carrara, Paolo; Pintor, Carlo; Dedoni, Maurizio; Dessì, Carlo; Loriano, Daniela; Anastasio, Elisa; Bezzi, Teresa; De Luca, Marco; Farina, Silvia; Vierucci, Alberto; Bassetti, Dante; Pontali, Emanuele; Boni, Silvia; Marazzi, Maria Grazia; Tasso, Loredana; Giovanettoni, Chiara; Salvini, Filippo; Pinzani, Raffaella; Marchisio, Paola; Viganò, Alessandra; Tornaghi, Raffaella; Zuccotti, Gian Vincenzo; Riva, Enrica; Giovannini, Marcello; Lipreri, Rita; Conio, Stefania; Ferraris, Gabriele; Cellini, Monica; Baraldi, Cecilia; Guarino, Alfredo; Canani, Roberto Berni; Tarallo, Luigi; Giaquinto, Carlo; Ruga, Ezia; Rampon, Osvalda; Nogare, Ernesto Renato Dalle; Sanfilippo, Adriana; Romano, Amelia; Benaglia, Giorgio; Dodi, Icilio; Caselli, Desirèe; Maccabruni, Anna; Pacati, Ilaria; Consolini, Rita; Palla, Gabriella; Cecchi, Maria Teresa; Vecchi, Vico; Anzidei, Gianfranco; Cerilli, Stefano; Chiodi, Rosa; Gattinara, Guido Castelli; Krzysztofiak, Andrea; Bernardi, Stefania; Fundarò, Carlo; Genovese, Orazio; Colafati, Giovanna Stefania; Catania, Salvatore; Ajassa, Camilla; Mazza, Antonio; Garetto, Sara; Riva, Caterina; Scolfaro, Carlo.

In: Journal of the American Medical Association, Vol. 284, No. 2, 12.07.2000, p. 190-197.

Research output: Contribution to journalArticle

de Martino, M, Tovo, PA, Balducci, M, Galli, L, Gabiano, C, Rezza, G, Pezzotti, P, Osimani, P, Di Bari, C, Larovere, D, Ruggeri, M, Masi, M, Specchia, F, Battisti, L, Duse, M, Crispino, P, Carrara, P, Pintor, C, Dedoni, M, Dessì, C, Loriano, D, Anastasio, E, Bezzi, T, De Luca, M, Farina, S, Vierucci, A, Bassetti, D, Pontali, E, Boni, S, Marazzi, MG, Tasso, L, Giovanettoni, C, Salvini, F, Pinzani, R, Marchisio, P, Viganò, A, Tornaghi, R, Zuccotti, GV, Riva, E, Giovannini, M, Lipreri, R, Conio, S, Ferraris, G, Cellini, M, Baraldi, C, Guarino, A, Canani, RB, Tarallo, L, Giaquinto, C, Ruga, E, Rampon, O, Nogare, ERD, Sanfilippo, A, Romano, A, Benaglia, G, Dodi, I, Caselli, D, Maccabruni, A, Pacati, I, Consolini, R, Palla, G, Cecchi, MT, Vecchi, V, Anzidei, G, Cerilli, S, Chiodi, R, Gattinara, GC, Krzysztofiak, A, Bernardi, S, Fundarò, C, Genovese, O, Colafati, GS, Catania, S, Ajassa, C, Mazza, A, Garetto, S, Riva, C & Scolfaro, C 2000, 'Reduction in mortality with availability of antiretroviral therapy for children with perinatal HIV-1 infection', Journal of the American Medical Association, vol. 284, no. 2, pp. 190-197.
de Martino, Maurizio ; Tovo, Pier Angelo ; Balducci, Maria ; Galli, Luisa ; Gabiano, Clara ; Rezza, Giovanni ; Pezzotti, Patrizio ; Osimani, Patrizia ; Di Bari, Cesare ; Larovere, Domenico ; Ruggeri, Maurizio ; Masi, Massimo ; Specchia, Fernando ; Battisti, Laura ; Duse, Marzia ; Crispino, Paola ; Carrara, Paolo ; Pintor, Carlo ; Dedoni, Maurizio ; Dessì, Carlo ; Loriano, Daniela ; Anastasio, Elisa ; Bezzi, Teresa ; De Luca, Marco ; Farina, Silvia ; Vierucci, Alberto ; Bassetti, Dante ; Pontali, Emanuele ; Boni, Silvia ; Marazzi, Maria Grazia ; Tasso, Loredana ; Giovanettoni, Chiara ; Salvini, Filippo ; Pinzani, Raffaella ; Marchisio, Paola ; Viganò, Alessandra ; Tornaghi, Raffaella ; Zuccotti, Gian Vincenzo ; Riva, Enrica ; Giovannini, Marcello ; Lipreri, Rita ; Conio, Stefania ; Ferraris, Gabriele ; Cellini, Monica ; Baraldi, Cecilia ; Guarino, Alfredo ; Canani, Roberto Berni ; Tarallo, Luigi ; Giaquinto, Carlo ; Ruga, Ezia ; Rampon, Osvalda ; Nogare, Ernesto Renato Dalle ; Sanfilippo, Adriana ; Romano, Amelia ; Benaglia, Giorgio ; Dodi, Icilio ; Caselli, Desirèe ; Maccabruni, Anna ; Pacati, Ilaria ; Consolini, Rita ; Palla, Gabriella ; Cecchi, Maria Teresa ; Vecchi, Vico ; Anzidei, Gianfranco ; Cerilli, Stefano ; Chiodi, Rosa ; Gattinara, Guido Castelli ; Krzysztofiak, Andrea ; Bernardi, Stefania ; Fundarò, Carlo ; Genovese, Orazio ; Colafati, Giovanna Stefania ; Catania, Salvatore ; Ajassa, Camilla ; Mazza, Antonio ; Garetto, Sara ; Riva, Caterina ; Scolfaro, Carlo. / Reduction in mortality with availability of antiretroviral therapy for children with perinatal HIV-1 infection. In: Journal of the American Medical Association. 2000 ; Vol. 284, No. 2. pp. 190-197.
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abstract = "Context. Since the introduction of combined antiretroviral therapy, mortality rates in adults with human immunodeficiency virus type 1 (HIV-1) infection have decreased. However, little information is available outside the setting of controlled trials on survival of perinatally HIV-infected children treated with antiretroviral therapy. Objective. To assess effect of availability of antiretroviral therapy on decreasing mortality in perinatally HIV-infected children. Design. Population-based, multicenter longitudinal study involving data collected by the Italian Register for HIV Infection in Children. Setting. A network of 106 pediatric clinical centers. Subjects. A total of 1142 children born between November 1980 and December 1997 with perinatally acquired HIV infection with a median follow - up of 5.9 years. Main Outcome Measure. Time to HIV-related death calculated for birth cohort and calendar period and grouped by distribution of predominant type of antiretroviral therapy administered over time. Results. Survival was longer in the 1996-1997 birth cohort (crude relative hazard [RH] of death, 0.39; 95{\%} confidence interval [Cl], 0.15-0.96) and 1996-1998 calendar period (crude RH of death, 0.65; 95{\%} Cl, 0.45-0.95) than in birth cohort and calendar period 1980-1995, but not when adjusted for maternal antiretroviral treatment during pregnancy and clinical condition at time of delivery, gestational age, and birth weight (adjusted RH of death, 0.55; 95{\%} Cl, 0.20-1.50, for birth cohort; and adjusted RH of death, 0.71, 95{\%} Cl, 0.43-1.16, for calendar period). In a multivariate model with 1980-1995 as comparison, the 1996-1997 birth cohort had an RH of 0.57 (95{\%} Cl, 0.22-1.47; P=27) but RH for calendar period 1996-1998 was 0.63 (95{\%} Cl, 0.47-0.85; P",
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T1 - Reduction in mortality with availability of antiretroviral therapy for children with perinatal HIV-1 infection

AU - de Martino, Maurizio

AU - Tovo, Pier Angelo

AU - Balducci, Maria

AU - Galli, Luisa

AU - Gabiano, Clara

AU - Rezza, Giovanni

AU - Pezzotti, Patrizio

AU - Osimani, Patrizia

AU - Di Bari, Cesare

AU - Larovere, Domenico

AU - Ruggeri, Maurizio

AU - Masi, Massimo

AU - Specchia, Fernando

AU - Battisti, Laura

AU - Duse, Marzia

AU - Crispino, Paola

AU - Carrara, Paolo

AU - Pintor, Carlo

AU - Dedoni, Maurizio

AU - Dessì, Carlo

AU - Loriano, Daniela

AU - Anastasio, Elisa

AU - Bezzi, Teresa

AU - De Luca, Marco

AU - Farina, Silvia

AU - Vierucci, Alberto

AU - Bassetti, Dante

AU - Pontali, Emanuele

AU - Boni, Silvia

AU - Marazzi, Maria Grazia

AU - Tasso, Loredana

AU - Giovanettoni, Chiara

AU - Salvini, Filippo

AU - Pinzani, Raffaella

AU - Marchisio, Paola

AU - Viganò, Alessandra

AU - Tornaghi, Raffaella

AU - Zuccotti, Gian Vincenzo

AU - Riva, Enrica

AU - Giovannini, Marcello

AU - Lipreri, Rita

AU - Conio, Stefania

AU - Ferraris, Gabriele

AU - Cellini, Monica

AU - Baraldi, Cecilia

AU - Guarino, Alfredo

AU - Canani, Roberto Berni

AU - Tarallo, Luigi

AU - Giaquinto, Carlo

AU - Ruga, Ezia

AU - Rampon, Osvalda

AU - Nogare, Ernesto Renato Dalle

AU - Sanfilippo, Adriana

AU - Romano, Amelia

AU - Benaglia, Giorgio

AU - Dodi, Icilio

AU - Caselli, Desirèe

AU - Maccabruni, Anna

AU - Pacati, Ilaria

AU - Consolini, Rita

AU - Palla, Gabriella

AU - Cecchi, Maria Teresa

AU - Vecchi, Vico

AU - Anzidei, Gianfranco

AU - Cerilli, Stefano

AU - Chiodi, Rosa

AU - Gattinara, Guido Castelli

AU - Krzysztofiak, Andrea

AU - Bernardi, Stefania

AU - Fundarò, Carlo

AU - Genovese, Orazio

AU - Colafati, Giovanna Stefania

AU - Catania, Salvatore

AU - Ajassa, Camilla

AU - Mazza, Antonio

AU - Garetto, Sara

AU - Riva, Caterina

AU - Scolfaro, Carlo

PY - 2000/7/12

Y1 - 2000/7/12

N2 - Context. Since the introduction of combined antiretroviral therapy, mortality rates in adults with human immunodeficiency virus type 1 (HIV-1) infection have decreased. However, little information is available outside the setting of controlled trials on survival of perinatally HIV-infected children treated with antiretroviral therapy. Objective. To assess effect of availability of antiretroviral therapy on decreasing mortality in perinatally HIV-infected children. Design. Population-based, multicenter longitudinal study involving data collected by the Italian Register for HIV Infection in Children. Setting. A network of 106 pediatric clinical centers. Subjects. A total of 1142 children born between November 1980 and December 1997 with perinatally acquired HIV infection with a median follow - up of 5.9 years. Main Outcome Measure. Time to HIV-related death calculated for birth cohort and calendar period and grouped by distribution of predominant type of antiretroviral therapy administered over time. Results. Survival was longer in the 1996-1997 birth cohort (crude relative hazard [RH] of death, 0.39; 95% confidence interval [Cl], 0.15-0.96) and 1996-1998 calendar period (crude RH of death, 0.65; 95% Cl, 0.45-0.95) than in birth cohort and calendar period 1980-1995, but not when adjusted for maternal antiretroviral treatment during pregnancy and clinical condition at time of delivery, gestational age, and birth weight (adjusted RH of death, 0.55; 95% Cl, 0.20-1.50, for birth cohort; and adjusted RH of death, 0.71, 95% Cl, 0.43-1.16, for calendar period). In a multivariate model with 1980-1995 as comparison, the 1996-1997 birth cohort had an RH of 0.57 (95% Cl, 0.22-1.47; P=27) but RH for calendar period 1996-1998 was 0.63 (95% Cl, 0.47-0.85; P

AB - Context. Since the introduction of combined antiretroviral therapy, mortality rates in adults with human immunodeficiency virus type 1 (HIV-1) infection have decreased. However, little information is available outside the setting of controlled trials on survival of perinatally HIV-infected children treated with antiretroviral therapy. Objective. To assess effect of availability of antiretroviral therapy on decreasing mortality in perinatally HIV-infected children. Design. Population-based, multicenter longitudinal study involving data collected by the Italian Register for HIV Infection in Children. Setting. A network of 106 pediatric clinical centers. Subjects. A total of 1142 children born between November 1980 and December 1997 with perinatally acquired HIV infection with a median follow - up of 5.9 years. Main Outcome Measure. Time to HIV-related death calculated for birth cohort and calendar period and grouped by distribution of predominant type of antiretroviral therapy administered over time. Results. Survival was longer in the 1996-1997 birth cohort (crude relative hazard [RH] of death, 0.39; 95% confidence interval [Cl], 0.15-0.96) and 1996-1998 calendar period (crude RH of death, 0.65; 95% Cl, 0.45-0.95) than in birth cohort and calendar period 1980-1995, but not when adjusted for maternal antiretroviral treatment during pregnancy and clinical condition at time of delivery, gestational age, and birth weight (adjusted RH of death, 0.55; 95% Cl, 0.20-1.50, for birth cohort; and adjusted RH of death, 0.71, 95% Cl, 0.43-1.16, for calendar period). In a multivariate model with 1980-1995 as comparison, the 1996-1997 birth cohort had an RH of 0.57 (95% Cl, 0.22-1.47; P=27) but RH for calendar period 1996-1998 was 0.63 (95% Cl, 0.47-0.85; P

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