Decline in mortality in children with HIV in the UK and Ireland: Argument is flawed

doi:10.1136/bmj.328.7438.523-b

BMJ 2004;328:523 (28 February), doi:10.1136/bmj.328.7438.523-b

Letter

Decline in mortality in children with HIV in the UK and Ireland

Argument is flawed

The first 150 words of the full text of this article appear below.

EDITOR—The claims by Gibb et al, that their evidence showsa decline in mortality of children with HIV/AIDS in the UnitedKingdom and Ireland (thanks to antiretrovirals), cannot go unchallenged.¹In their methods section they make little or no reference tothe management of opportunistic infections. Furthermore, wehave no idea how and where these children were delivered.

View larger version (39K):
[in this window]
[in a new window]

Risk of AIDS/death or death by year relative to 1996

Were some of these children delivered by caesarean section?This may be important since some authors have asked whetherthe protective effect of caesarean delivery independent of zidovudineprophylaxis can be further investigated by a large, international,individual patient data meta-analysis of observational studies.A definitive answer to the question will require a randomisedclinical trial, which is the only method to ensure that womenwho undergo an elective caesarean delivery do not differ fromthose with other types of . . . [Full text of this article]

S W P Mhlongo, chief specialist

ansie@wn.apc.org, Department of Family Medicine and Primary Health Care, Medunsa (Medical University of South Africa) 0204, Pretoria, Gauteng

P M H Maduna, principal specialist

Department of Family Medicine and Primary Health Care, Medunsa (Medical University of South Africa) 0204, Pretoria, Gauteng

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Descriptive survey of non-commercial randomised controlled trials in the United Kingdom, 1980-2002: Iain Chalmers, Cath Rounding, and Kate Lock
BMJ 2003 327: 1017. [Abstract] [Full Text] [PDF]

Decline in mortality, AIDS, and hospital admissions in perinatally HIV-1 infected children in the United Kingdom and Ireland: D M Gibb, T Duong, P A Tookey, M Sharland, G Tudor-Williams, V Novelli, K Butler, A Riordan, L Farrelly, J Masters, C S Peckham, and D T Dunn
BMJ 2003 327: 1019. [Abstract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

AIDS - HAART retroviral theraqpy revisited: Etienne P. de Harven, et al.
bmj.com, 14 Mar 2004 [Full text]
Re: AIDS - HAART retroviral theraqpy revisited: Peter J Flegg
bmj.com, 16 Mar 2004 [Full text]
Cause of beneficial effects of HAART potentially misinterpreted: Nicholas D. Chester
bmj.com, 2 Apr 2004 [Full text]
Re: Cause of beneficial effects of HAART potentially misinterpreted: Peter Flegg
bmj.com, 5 Apr 2004 [Full text]
HAART: One foot on the gas pedal, the other on the brake!: David Rasnick
bmj.com, 5 Apr 2004 [Full text]
Re: Cause of beneficial effects of HAART potentially misinterpreted: Eleni Papadopulos-Eleopulos, et al.
bmj.com, 6 Apr 2004 [Full text]
Perth Group misinterpretations: Peter Flegg
bmj.com, 9 Apr 2004 [Full text]
Can Peter Flegg prove 'HIV' existence?: Alexander H Russell
bmj.com, 9 Apr 2004 [Full text]
Response to Russell: even Duesberg has "proved HIV existence": Peter Flegg
bmj.com, 15 Apr 2004 [Full text]
Response to Peter Flegg: Alexander H Russell
bmj.com, 21 Apr 2004 [Full text]
Response to Alex Russell: Peter Flegg
bmj.com, 22 Apr 2004 [Full text]
Flegg has still not proved the existence of 'HIV': Alexander H Russell
bmj.com, 24 Apr 2004 [Full text]
Re: Flegg has still not proved the existence of 'HIV': Etienne de Harven
bmj.com, 27 Apr 2004 [Full text]
The dissident Emperor's new clothes.: Peter Flegg
bmj.com, 27 Apr 2004 [Full text]
Reviving Flegg's fading hope: Alexander H Russell
bmj.com, 28 Apr 2004 [Full text]
HIV-induced apoptosis: Peter Flegg
bmj.com, 29 Apr 2004 [Full text]
Re: HIV-induced apoptosis-correction: Peter Flegg
bmj.com, 29 Apr 2004 [Full text]
Final challenge to Flegg: Alexander H Russell
bmj.com, 29 Apr 2004 [Full text]
Final response to Russell: Peter Flegg
bmj.com, 30 Apr 2004 [Full text]
Re: Perth Group misinterpretations: Eleni Papadopulos-Eleopulos, et al.
bmj.com, 30 Apr 2004 [Full text]
Dr. Flegg's continued obfuscation: where is the evidence that 'HIV' exists?: Alexander H Russell
bmj.com, 3 May 2004 [Full text]
Re: Response to Russell: even Duesberg has "proved HIV existence": Eleni Papadopulos-Eleopulos, et al.
bmj.com, 3 May 2004 [Full text]
Re: Re: Response to Russell: even Duesberg has "proved HIV existence": Simon Portsmouth
bmj.com, 3 May 2004 [Full text]
Re: Re: Response to Russell: even Duesberg has "proved HIV existence": Peter Flegg
bmj.com, 4 May 2004 [Full text]
Re: Re: Re: Response to Russell: even Duesberg has "proved HIV existence": Eleni Papadopulos-Eleopulos, et al.
bmj.com, 6 May 2004 [Full text]
Duesberg has not provided visual proof for the existence of 'HIV'.: Alexander H Russell
bmj.com, 10 May 2004 [Full text]
Re: Duesberg has not provided visual proof for the existence of 'HIV'.: Peter Flegg
bmj.com, 11 May 2004 [Full text]
Perth Group misinterpretations and HIV-apoptosis: Peter Flegg
bmj.com, 11 May 2004 [Full text]
Re: Re: Duesberg has not provided visual proof for the existence of 'HIV'.: Alexander H Russell
bmj.com, 25 May 2004 [Full text]
Re: Re: Re: Duesberg has not provided visual proof for the existence of 'HIV'.: Peter J Flegg
bmj.com, 26 May 2004 [Full text]
here we go again!: Bob Bury
bmj.com, 27 May 2004 [Full text]