November 30, 2023
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Key takeaways:
- Among people receiving treatment for HIV, young children have the highest mortality rate.
- Death among children aged younger than 5 years with HIV was 2 to 9 times more common than in older patients.
Among people being treated for HIV, young children experience the highest rate of death — up to nine times higher than other age groups, according to study findings published in MMWR.
Disparities in mortality between children and older people receiving ART have not been well described, according to the study’s authors.
Data derived from Agathis NT, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7248a1.
“Given the relatively high global mortality rates among children aged [younger than] 5 years in general, those living with HIV receiving ART might experience excessively high mortality compared with older persons living with HIV receiving ART,” they wrote.
The researchers analyzed data from 28 countries and regions supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) from October 2020 to September 2022.
According to the data, 4.9% of babies aged younger than 1 year on ART and 2.5% of toddlers aged 1 to 4 years on ART die each year compared with 0.5% of children aged 5 to 14 years, 0.7% of people aged 15 to 49 years and 1.4% of people aged 50 years or older.
The findings underscore the persistent risk of death among young children with HIV despite being on HIV treatment and emphasize the need to deliver timely HIV and other pediatric health services to promote their survival and well-being, the authors wrote.
They listed these strategies to optimize HIV care for children living with the disease:
- diagnosing children as early as possible, and linking them to optimized ART (especially dolutegravir-based regimens);
- ensuring that these children continue in effective HIV care and treatment through family-centered, differentiated service delivery models; and
- comprehensively preventing, identifying, and managing advanced HIV disease and its complications, including tuberculosis and severe acute malnutrition, according to the WHO STOP AIDS Package.
“These strategies, as highlighted in PEPFAR’s 2023 country and regional operational planning guidance, have the potential to prevent death, reduce the inequities experienced by children aged [younger than] 5 years living with HIV, and contribute to the global measures to end AIDS among children by 2030,” they wrote.
References:
Agathis NT, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7248a1.
New report finds high death rates among children living with HIV on treatment. https://www.cdc.gov/globalhivtb/what-we-do/pediatrichiv/pediatric-mmwr.html. Nov. 30, 2023. Accessed Nov. 30, 2023.
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