Final Height and Associated Factors in Perinatally HIV-infected Asian Adolescents

Bunupuradah, Torsak; Kariminia, Azar; Aurpibul, Linda; Chokephaibulkit, Kulkanya; Hansudewechakul, Rawiwan; Lumbiganon, Pagakrong; Saphonn, Vonthanak; Vibol, Ung; Saghayam, Suneeta; Nallusamy, Revathy; Nguyen, Lam Van; Yusoff, Nik Khairulddin Nik; Sohn, Annette H.; Puthanakit, Thanyawee

doi:10.1097/inf.0000000000000961

Cited by 16 publications

(16 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Congruent with other studies which assessed immunologic recovery in children [25–27], our findings also show that there is a positive relation between anthropometric indices and immunologic recovery at follow up. Specifically, the HAZ at both ART initiation and follow up was found to be positively correlated with the CD4 percentage at follow up.…”

Section: Discussionsupporting

confidence: 90%

Anthropometric Improvement among HIV Infected Pre-School Children Following Initiation of First Line Anti-Retroviral Therapy: Implications for Follow Up

et al. 2016

View full text Add to dashboard Cite

BackgroundAntiretroviral therapy (ART) is a lifesaving intervention for HIV infected children. There is a scarcity of data on immunological recovery and its relation with growth indicators among HIV infected young children. The current study aims to assess the pattern of anthropometric Z-score improvement following initiation of first-line ART among under-five children and the relationship between anthropometric Z-score improvement and immunologic recovery.MethodsWe included under-five children who were on first-line ART at five major hospitals in Addis Ababa, Ethiopia. We measured anthropometry and collected clinical and laboratory data at follow up, and we retrieved clinical and anthropometric data at ART initiation from records. Z-scores for each of the anthropometric indices were calculated based on WHO growth standards using ENA for SMART 2011 software. Linear regression was used to assess the relationship between time on ART and anthropometric Z-score improvement; and the relationship between anthropometric Z-score improvement and immunologic recovery. Multiple linear regression was used to assess the independent predictors of anthropometric Z-score change.ResultsThe median age of the participants was 4.1 (Interquartile range (IQR): 3.3–4.9) years. More than half (52.48%) were female. The median duration of follow up was 1.69 (IQR: 1.08–2.63) years. There was a significant improvement in all anthropometric indices at any follow up after initiation of first-line ART (underweight; 39.5% vs16.5%, stunting; 71.3% vs 62.9% and wasting; 16.3% vs 1.0%; p-value< 0.0001). There was an inverse relationship between improvement in weight for age Z-score (WAZ) and duration of ART (R2 = 0.04; F (1, 158); p = 0.013). Height for age Z-score (HAZ) both at the time of ART initiation and follow up has a positive linear relationship with CD4 percentage at follow up (Coef. = 1.92; R2 = 0.05; p-value = 0.002). Duration on ART (Std. Err. = 0.206, t = -1.99, p-value = 0.049) and level of maternal education (Std. Err. = 0.290, t = 2.64, p-value = 0.009) were the only independent predictors of the change in WAZ and change in HAZ at any follow up visit respectively.ConclusionThere was a significant improvement in all anthropometric indices at any follow-up after initiation of first-line ART among under-five children. HAZ was linearly related with immunologic recovery following ART initiation. The findings indicate that anthropometric indices could be taken as proxy indicators of immunologic recovery for under-five children.

show abstract

Section: Discussionsupporting

confidence: 90%

Anthropometric Improvement among HIV Infected Pre-School Children Following Initiation of First Line Anti-Retroviral Therapy: Implications for Follow Up

et al. 2016

View full text Add to dashboard Cite

show abstract

“…[17,18] One in four children in our cohort had chronic lung disease, a well-known complication among PHIV adolescents, particularly in sub-Saharan Africa. [19,20] Despite HAZ improvements in childhood, in this study and others in LMICs [21,22] PHIV adolescents continue to be at least one standard deviation below normal height, with potential impact on final adult height.…”

Section: Researchmentioning

confidence: 53%

Treatment outcomes in perinatally infected HIV-positive adolescents and young adults after ≥10 years on antiretroviral therapy

Anderson

Muloiwa

2018

S Afr Med J

View full text Add to dashboard Cite

show abstract

“…Most studies described improvements in HAZ [53, 54], height gain or even percentage increase [25, 55, 56] in relation to ART. In one study in Asian children among 273 perinatally HIV-infected adolescents [median age at ART initiation, 11.4 years], 19% were stunted according to the Thai child growth reference and half of those remained stunted over time [57]. However, in most studies, the follow-up duration was relatively short, and only one study in Spain examined the height evolution after a median follow up of 71 months [58].…”

Section: Discussionmentioning

confidence: 99%

Impact of antiretroviral treatment on height evolution of HIV infected children

et al. 2019

View full text Add to dashboard Cite

Background Antiretroviral treatment (ART) has been shown to have a beneficial effect on the weight evolution but its effect on height remains unclear. We described patterns of height evolution and identified predictors of catch-up growth in HIV-infected children on ART. Methods To describe the height evolution from birth to adulthood, we developed a nonlinear mixed effect model using data from perinatally HIV-infected children who initiated ART from 1999 to 2013 in a prospective cohort study in Thailand. The main covariates of interest were: sex, ART regimen (dual nucleoside reverse-transcriptase inhibitor, non-nucleoside reverse transcriptase inhibitor (NNRTI)-, or protease inhibitor (PI)-based), baseline CD4 percentage, HIV-RNA load and CDC HIV Classification stage and occurrence of AIDS-defining events. Results A total 477 children (43% boys) contributed 18,596 height measurements over a median duration of 6.3 years on ART (interquartile range, 3.0 to 8.3). At ART initiation, median age was 6.2 years (1.8 to 9.6), 16% of children were underweight (weight-for-age z-score < − 2), 49% presented stunting (height-for-age z-score < − 2), and 7% wasting (weight-for-height z-score < − 2). The most frequent regimen at ART initiation was NNRTI-based (79%). A model with 4 components, birth length and 3 exponential functions of age accounting for the 3 growth phases was developed and show that the height-growth velocity was inversely associated with the age at ART initiation, the adult height was significantly lower in those who had experienced at least one AIDS-defining event while, as expected, the model found that adult height in females was lower than in males. Age at ART initiation, type of ART regimen, CDC stage, CD4 percentages, and HIV-RNA load were not associated with the final height. Conclusions The younger the children at ART initiation, the greater the effect on height-growth velocity, supporting the World Health Organization’s recommendation to start ART as early as possible. However, final adult height was not linked to the age at ART initiation. Electronic supplementary material The online version of this article (10.1186/s12887-019-1663-8) contains supplementary material, which is available to authorized users.

show abstract

Final Height and Associated Factors in Perinatally HIV-infected Asian Adolescents

Cited by 16 publications

References 10 publications

Anthropometric Improvement among HIV Infected Pre-School Children Following Initiation of First Line Anti-Retroviral Therapy: Implications for Follow Up

Anthropometric Improvement among HIV Infected Pre-School Children Following Initiation of First Line Anti-Retroviral Therapy: Implications for Follow Up

Treatment outcomes in perinatally infected HIV-positive adolescents and young adults after ≥10 years on antiretroviral therapy

Impact of antiretroviral treatment on height evolution of HIV infected children

Contact Info

Product

Resources

About