Ebonyi, AugustineOguche, StephenMeloni, SeemaSagay, SolomonKyriacou, DemetriosAchenbach, ChadAgbaji, OcheOyebode, TinuadeOkonkwo, ProsperIdoko, JohnKanki, Phyllis2016-09-302014Ebonyi, Augustine O, Stephen Oguche, Seema T Meloni, Solomon A Sagay, Demetrios N Kyriacou, Chad J Achenbach, Oche O Agbaji, Tinuade A Oyebode, Prosper Okonkwo, John A Idoko, and Phyllis J Kanki. 2014. Predictors of Mortality in a Clinic Cohort of HIV-1 Infected Children Initiated on Antiretroviral Therapy in Jos, Nigeria. J AIDS Clin Res. 5: 403. doi:10.4172/2155-6113.1000403.2155-6113http://nrs.harvard.edu/urn-3:HUL.InstRepos:28717394Background: Mortality among Human Immunodeficiency Virus-1 (HIV-1) infected children initiated on Antiretroviral Therapy (ART) though on a decline still remains high in resource-limited countries. Identifying baseline factors that predict mortality could allow their possible modification in order to improve pediatric HIV care and reduce mortality. Methods: We conducted a retrospective cohort study analyzing data on 691 children, aged 2 months-15 years, diagnosed with HIV-1 infection and initiated on ART between July 2005 and March 2013 at the pediatric HIV clinic of Jos University Teaching Hospital. Lost to follow-up children were excluded from the analyses. A multivariate Cox proportional hazards model was fitted to identify predictors of mortality. Results: Median follow-up time for the 691 children initiated on ART was 4.4 years (interquartile range (IQR), 1.8-5.9) and at the end of 2752 person-years of follow-up, 32 (4.6%) had died and 659 (95.4%) survived. The mortality rate was 1.0 per 100 child-years of follow-up period. The median age of those who died was about two times lower than that of survivors [1.7 years (IQR, 0.6-3.6) versus 3.9 years (IQR, 3.9 - 10.3), p<0.001]. On unadjusted Cox regression, the risk of dying was about three and half times more in children <5 years of age compared to those >5 years (p=0.02) Multivariate modeling identified age as the main predictor of death with mortality decreasing by 24% for every 1 year increase in age (Adjusted Hazard Ratio (AHR)=0.76 [0.62-0.94], p=0.013. Conclusion: The lower mortality rate for our study suggests that even in RLCs, mortality rates could be reduced given a good standard of care. Early initiation of ART in younger children with close monitoring during follow-up could further reduce mortality.en-USHIV-1mortalitysevere immunodeficiencyARTchildrenJournal Article2016-09-3010.4172/2155-6113.1000403