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

doi:10.1136/bmj.328.7438.524-a

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Authors' reply

D M Gibb, reader in epidemiology (mbh@ctu.mrc.ac.uk),
T Duong, statistician,
P A Tookey, senior lecturer in paediatric epidemiology

Medical Research Council Clinical Trials Unit, London NW1 2DA
Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London WC1N 1EH

EDITOR—Mhlongo and Maduna and Prime et al challenge the results of our study and think that we overlooked alternative reasons for the rapid fivefold decline in mortality, progression to AIDS, and hospital admission rates we reported in the CHIPS cohort of vertically HIV infected children in the United Kingdom and Ireland. We cannot agree that they provide viable alternative explanations for the dramatic reduction.

Firstly, we did not include details of management of opportunistic infections, and we agree that there is indirect evidence that cotrimoxazole prophylaxis reduces the frequency of these (particularly Pneumocystis carinii pneumonia in infancy, as previously reported in the United Kingdom1 …