Author Contributions: Dr Stringer had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: J. Stringer, Zulu, Levy, E. Stringer, Mwango, Chi, Mtonga, Cantrell, Bulterys, Saag, Mwinga, Sinkala.
Acquisition of data: J. Stringer, Levy, Reid.
Analysis and interpretation of data: J. Stringer, Zulu, Levy, E. Stringer, Mwango, Chi, Mtonga, Cantrell, Bulterys, Saag, Marlink, Ellerbrock, Sinkala.
Drafting of the manuscript: J. Stringer, Levy, Bulterys, Saag.
Critical revision of the manuscript for important intellectual content: J. Stringer, Zulu, Levy, E. Stringer, Mwango, Chi, Mtonga, Reid, Cantrell, Bulterys, Saag, Marlink, Mwinga, Ellerbrock, Sinkala.
Statistical analysis: J. Stringer, Levy, Cantrell.
Obtained funding: J. Stringer, Bulterys, Marlink, Mwinga.
Administrative, technical, or material support: J. Stringer, Zulu, Levy, E. Stringer, Mwango, Chi, Mtonga, Reid, Cantrell, Marlink, Ellerbrock, Sinkala.
Study supervision: J. Stringer, Zulu, Levy, E. Stringer, Mwango, Chi, Mtonga, Reid, Cantrell, Bulterys, Sinkala.
Financial Disclosures: Dr Saag reported that he had grant/research support from Gilead Sciences, GlaxoSmithKline, Panacos, Pfizer/Agouron, Roche Laboratories, Serono, and Tibotec; was a consultant and on the speakers bureau for Achillion Pharmaceutical, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Panacos, Pfizer/Agouron, Progenics, Roche Laboratories, Tanox, Tibotec/Virco, Trimeris, Vertex, and ViroLogic.
Funding/Support: This work was supported by a multicountry grant to the Elizabeth Glaser Pediatric AIDS Foundation from the US Centers for Disease Control and Prevention (U62/CCU12354). Additional investigator salary support is provided by the National Institutes of Health grants K23-AI01411; K01-TW05708; K01-TW06670; and P30-AI027767 and the Elizabeth Glaser Pediatric AIDS Foundation grant EGSA 19-02.
Role of the Sponsor: The CDC was not involved in data collection or management, but through coauthors (Drs Bulterys, Mwango, and Ellerbrock) and the CDC manuscript “clearance” process, the CDC was substantially involved in the preparation, review, and approval of the manuscript. The NIH was not involved in the design or conduct of the study, collection, management, analysis, or interpretation of the data, nor was it involved in preparation, review, or approval of the manuscript. The Elizabeth Glaser Pediatric AIDS Foundation was not involved in data collection, management, or analysis, but through collaborator Richard Marlink, MD, was involved in design of the study, data interpretation, and manuscript preparation, review, and approval. There were no industry sponsors of this study.
Previous Presentation: These data were presented in part at the 12th Conference on Retroviruses and Opportunistic Infections, February 22-25, 2005; Boston, Mass, Abstract 638b, and at the 13th Conference on Retroviruses and Opportunistic Infections, February 5-8, 2006; Denver, Colo, Abstract 64.
Statistical Analysis: The statistical analysis was conducted by Jens Levy, MS, Ronald A. Cantrell, MPH, and Jeffrey S. A. Stringer, MD.
Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the CDC or the US Department of Health and Human Services.
Acknowledgment: The authors wish to acknowledge and thank Carolyn Bolton, MBBS (Centre for Infectious Disease Research in Zambia [CIDRZ]), Elwyn Chomba, MBChB (University of Zambia [UNZA]), Andrew Coyle (CIDRZ), Annabelle Degroot, MA (CIDRZ), Harmony Fusco, MA (CIDRZ), Robert Goldenberg, MD (University of Alabama at Birmingham [UAB]), Christophe Grundmann, PhD (Elizabeth Glaser Pediatric AIDS Foundation [EGPAF]), Charity Kalunga (CIDRZ), Chipepo Kankasa, MBBS (UNZA), Christine Kaseba, MBChB (UNZA), Michael Kimmerling, MD (UAB), Inder Kumar (CIDRZ), Iris Mwanza, PhD (CIDRZ), Mary Morris, MS (CIDRZ), Peter Mwaba, MD, PhD (UNZA), Cornelius Namiluko (CIDRZ), Erin Simmers (CIDRZ), Angela Taylor (CIDRZ), Sten Vermund, MD, PhD (Vanderbilt University), Sierra Washington (University of California—San Francisco), Larry Westerman, PhD (CIDRZ), Catherine Wilfert, MD (EGPAF), and Craig Wilson, MD (UAB) for their contributions to the program described herein; Dwight Rouse, MD, MSPH (UAB) and Ann Chao, PhD (Centers for Disease Control and Prevention [CDC]) for their thoughtful reviews of the manuscript; and Alain Degroot (CIDRZ), Thomas Hubschman (CIDRZ), Derek Muneene (CDC), Vernon Mweeta (CIDRZ), and Mark Shields, MD, MPH (CDC) for their contribution to the data collection system. None received compensation.