RESEARCH ARTICLE
Sex Differences in Antiretroviral Therapy Initiation in Pediatric HIV Infection Masahiko Mori1☯, Emily Adland1☯, Paolo Paioni1☯, Alice Swordy1, Luisa Mori1, Leana Laker2, Maximilian Muenchhoff1, Philippa C. Matthews1, Gareth Tudor-Williams3, Nora Lavandier1, Anriette van Zyl2, Jacob Hurst4, Bruce D. Walker5,6, Thumbi Ndung’u6,7,8, Andrew Prendergast9, Philip Goulder1,6‡*, Pieter Jooste2‡
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1 Department of Paediatrics, University of Oxford, Oxford, United Kingdom, 2 Kimberley Hospital, Kimberley, Durban, South Africa, 3 Department of Paediatrics, Imperial College, London, United Kingdom, 4 Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom, 5 Ragon Institute of MGH, MIT and Harvard, Boston, MA, United States of America, 6 Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa, 7 KwaZulu-Natal Research Institute for Tuberculosis and HIV (KRITH), University of KwaZulu-Natal, Durban, South Africa, 8 Max Planck Institute for Infection Biology, Berlin, Germany, 9 Centre for Paediatrics, Blizard Institute, Queen Mary University of London, London, United Kingdom ☯ These authors contributed equally to this work. ‡ These authors also contributed equally to this work. * [email protected]
OPEN ACCESS Citation: Mori M, Adland E, Paioni P, Swordy A, Mori L, Laker L, et al. (2015) Sex Differences in Antiretroviral Therapy Initiation in Pediatric HIV Infection. PLoS ONE 10(7): e0131591. doi:10.1371/ journal.pone.0131591 Editor: Clive M. Gray, University of Cape Town, SOUTH AFRICA Received: February 9, 2015 Accepted: June 2, 2015 Published: July 7, 2015 Copyright: © 2015 Mori et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files (S1 Table). Funding: This study was supported by http://www. wellcome.ac.uk. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Abstract The incidence and severity of infections in childhood is typically greater in males. The basis for these observed sex differences is not well understood, and potentially may facilitate novel approaches to reducing disease from a range of conditions. We here investigated sex differences in HIV-infected children in relation to antiretroviral therapy (ART) initiation and post-treatment outcome. In a South African cohort of 2,101 HIV-infected children, we observed that absolute CD4+ count and CD4% were significantly higher in ARTnaïve female, compared to age-matched male, HIV-infected children. Absolute CD4 count and CD4% were also significantly higher in HIV-uninfected female versus male neonates. We next showed that significantly more male than female children were initiated on ART (47% female); and children not meeting criteria to start ART by >5yrs were more frequently female (59%; p
Sex Differences in Antiretroviral Therapy Initiation in Pediatric HIV Infection Masahiko Mori1☯, Emily Adland1☯, Paolo Paioni1☯, Alice Swordy1, Luisa Mori1, Leana Laker2, Maximilian Muenchhoff1, Philippa C. Matthews1, Gareth Tudor-Williams3, Nora Lavandier1, Anriette van Zyl2, Jacob Hurst4, Bruce D. Walker5,6, Thumbi Ndung’u6,7,8, Andrew Prendergast9, Philip Goulder1,6‡*, Pieter Jooste2‡
a11111
1 Department of Paediatrics, University of Oxford, Oxford, United Kingdom, 2 Kimberley Hospital, Kimberley, Durban, South Africa, 3 Department of Paediatrics, Imperial College, London, United Kingdom, 4 Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom, 5 Ragon Institute of MGH, MIT and Harvard, Boston, MA, United States of America, 6 Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa, 7 KwaZulu-Natal Research Institute for Tuberculosis and HIV (KRITH), University of KwaZulu-Natal, Durban, South Africa, 8 Max Planck Institute for Infection Biology, Berlin, Germany, 9 Centre for Paediatrics, Blizard Institute, Queen Mary University of London, London, United Kingdom ☯ These authors contributed equally to this work. ‡ These authors also contributed equally to this work. * [email protected]
OPEN ACCESS Citation: Mori M, Adland E, Paioni P, Swordy A, Mori L, Laker L, et al. (2015) Sex Differences in Antiretroviral Therapy Initiation in Pediatric HIV Infection. PLoS ONE 10(7): e0131591. doi:10.1371/ journal.pone.0131591 Editor: Clive M. Gray, University of Cape Town, SOUTH AFRICA Received: February 9, 2015 Accepted: June 2, 2015 Published: July 7, 2015 Copyright: © 2015 Mori et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files (S1 Table). Funding: This study was supported by http://www. wellcome.ac.uk. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Abstract The incidence and severity of infections in childhood is typically greater in males. The basis for these observed sex differences is not well understood, and potentially may facilitate novel approaches to reducing disease from a range of conditions. We here investigated sex differences in HIV-infected children in relation to antiretroviral therapy (ART) initiation and post-treatment outcome. In a South African cohort of 2,101 HIV-infected children, we observed that absolute CD4+ count and CD4% were significantly higher in ARTnaïve female, compared to age-matched male, HIV-infected children. Absolute CD4 count and CD4% were also significantly higher in HIV-uninfected female versus male neonates. We next showed that significantly more male than female children were initiated on ART (47% female); and children not meeting criteria to start ART by >5yrs were more frequently female (59%; p
