Early neurodevelopmental markers predictive of mortality in infants infected with HIV-1

Antolin Llorente, Pim Brouwers, Manhattan Charurat, Laurence Magder, Kathleen Malee, Claude Mellins, Janice Ware, Joan Hittleman, Lynne Mofenson, Jesus Velez-Borras, Samuel Adeniyi-Jones

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Abstract

One-hundred and fifty-seven vertically infected HIV-1 positive infants (85 males, 72 females) underwent longitudinal assessment to determine whether early neurodevelopmental markers are useful predictors of mortality in those infants who survive to at least 4 months of age. Survival analysis methods were used to estimate time to death for quartiles of 4-month scores (baseline) on the Bayley Scales of Infant Development (BSID). Cox proportional hazards progression was used to estimate relative hazard (RH, 95% CI) of death for BSID scores and potential confounders. Thirty infants with BSID scores at 4 months of age died during follow-up. Survival analysis revealed greater mortality rates in infants with BSID (Mental Developmental Index and Psychomotor Developmental Index) scores in the lower quartile (p=0.004, p=0.036). Unadjusted univariate analyses revealed increased mortality associated with baseline CD4+ 29%, gestational age <37 weeks, smaller head circumference, advanced HIV and higher plasma viral load. BSID scores independently predicted mortality after adjusting for treatment, clinical category, gestational age, plasma viral load and CD4+ percentage.

Original languageEnglish (US)
Pages (from-to)76-84
Number of pages9
JournalDevelopmental Medicine and Child Neurology
Volume45
Issue number2
DOIs
StatePublished - Feb 1 2003

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Clinical Neurology

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    Llorente, A., Brouwers, P., Charurat, M., Magder, L., Malee, K., Mellins, C., Ware, J., Hittleman, J., Mofenson, L., Velez-Borras, J., & Adeniyi-Jones, S. (2003). Early neurodevelopmental markers predictive of mortality in infants infected with HIV-1. Developmental Medicine and Child Neurology, 45(2), 76-84. https://doi.org/10.1111/j.1469-8749.2003.tb00909.x