Antiretroviral Therapy Nutritional Status and Other Baseline Predictors of Mortality among HIV-Infected Children Initiating Antiretroviral Therapy in Tanzania

Background:We assembled a prospective cohort of 3144 children less than 15 years of age initiating antiretroviral therapy (ART) in Dar es Salaam, Tanzania.Methods: The relationships of nutritional status and other baseline characteristics in relation to mortality were examined usingCox proportional hazardsmodel.Results:Comparedwith childrenwithweight for age (WAZ)>-1, thosewith WAZ -2 to <-3 had a nearly double risk of death (relative risk [RR], 1.85; 95 % confidence interval [CI], 1.10-3.11), and among those with WAZ -3, the risk more than tripled (RR, 3.36; 95 % CI, 2.12-5.32). Other baseline risk factors for overall mortality included severe anemia (P <.001), severe immune suppression (P =.02), history of tuberculosis (P =.01), opportunistic infections (P <.001), living in the poorest district (P <.001), and advanced World Health Organization stage (P =.003). Conclusions: To sustain the obtained benefit of ART in this setting, interventions to improve nutritional status may be used as an adjunct to ART