Growth of Human Immunodeficiency Virus-Infected Children Receiving Highly Active Antiretroviral Therapy

Nachman, Sharon; Lindsey, Jane C.; Moye, John; Stanley, Kenneth; Johnson, George M.; Krogstad, Paul; Wiznia, Andrew

doi:10.1097/01.inf.0000157095.75081.43

Cited by 87 publications

(87 citation statements)

References 19 publications

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“…16 On the other hand, after the antiretroviral drugs started to be used, the weight usually improves during the first year, and the height usually improves after the second year. 17 The high prevalence of dyslipidemia (88.3%) found in the present study is above the rate found in the literature. 8,18,19 This may have been caused by the fact that the references used for the analysis of serum lipids had a higher cutoff point.…”

Section: Discussionsupporting

confidence: 73%

Síndrome da lipodistrofia e fatores de risco cardiovasculares em crianças e adolescentes infectados pelo HIV/AIDS em uso de terapia antirretroviral de alta potência

Werner

Pone

Fonseca

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To describe lipid profile, body shape changes, and cardiovascular risk factors in children and adolescents infected with HIV/AIDS receiving highly active antiretroviral therapy. Methods:We investigated 43 children and adolescents being treated with this therapy at the outpatient clinic of pediatric infectious diseases of Instituto Fernandes Figueira/Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. Values of total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides were determined. We also performed glucose tolerance test and analyzed body fat distribution, nutritional status, dietary intake, and family history of cardiovascular risk. The statistical analysis was performed using Student's t test. Significance level of pvalue was lower than 0.05. Results:We found lipid abnormality in 88.3% and body shape change in 13.9% of the cases. Nutritional status was adequate (81.3%) in most of the study population. Cholesterol intake in children older than 9 years was above the recommended value. Conclusion:Prevalence of dyslipidemia and, therefore, risk for cardiovascular diseases were high during the use of highly active antiretroviral therapy.

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Section: Discussionsupporting

confidence: 73%

Síndrome da lipodistrofia e fatores de risco cardiovasculares em crianças e adolescentes infectados pelo HIV/AIDS em uso de terapia antirretroviral de alta potência

Werner

Pone

Fonseca

et al. 2010

J. Pediatr. (Rio J.)

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“…[4][5][6] Many studies from developed countries using protease inhibitor (PI)-based ART regimen showed an improvement in growth of HIV-infected children after initiating ART. [7][8][9] Studies from Kenya and Uganda also showed significant improvements in weight and height as well as immunological and virologic parameters of perinatally HIVinfected children after ART initiation. 10,11 We had reported on the efficacy of ART in children participating in Thailand's national access to antiretroviral program.…”

mentioning

confidence: 99%

Reversal of Growth Failure in HIV-Infected Thai Children Treated with Non-Nucleoside Reverse Transcriptase Inhibitor–Based Antiretroviral Therapy

Aurpibul

Puthanakit

Taecharoenkul

et al. 2009

AIDS Patient Care and STDs

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Growth failure is a common problem in HIV-infected children. The extent to which this growth failure could be reversed after the children receive antiretroviral therapy (ART) is not known. This study assessed the incidence of growth failure in HIV-infected Thai children, impact of ART on growth, and the predictors of growth reversal after initiating ART. Growth parameters and other characteristics were extracted from the database of a prospective cohort of HIV-infected children (age 15 years) who were enrolled to initiate non-nucleoside reverse transcriptase inhibitor-based ART between August 2002 and May 2007. Body weight and height measurements, CD4 cell counts, plasma HIV RNA levels were collected at baseline and 24-week intervals. A total of 225 HIV-infected children were included, 116 (51%) were males. The median age at baseline was 7.4 years (interquartile range [IQR] 5.2-9.8). Fifty-three percent were in Centers for Disease Control and Prevention (CDC) category C and 54% had CD4 percentage 5 or less. The mean (standard deviation [SD]) of baseline weight-for-age (WAZ) and height-forage (HAZ) z-scores were À2.02 (1.17) and À2.22 (1.51). The median follow-up time was 216 weeks (IQR 120-240). The cumulative probability of growth reversal among the 179 subjects with growth failure at entry was 58% (95% confidence interval [CI] 49-67) at week 240. In a multivariate Cox regression model, higher entry WAZ ( p < 0.001) and HAZ ( p < 0.001), use of a nevirapine-based regimen (compared to efavirenz, p ¼ 0.027) and larger CD4% gains to week 48 ( p < 0.001) were significant predictors of growth reversal after initiating ART. NNRTI-based ART leads to a substantial improvement in growth of HIV-infected children. Initiation of ART before the children developed growth failure should be encouraged.

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“…Baseline growth parameters in our cohort were worse than reported from the United States [28,29] and Spain [30] but similar to those reported from Thailand [10] and India [31]. Aurbipol et al report higher entry WAZ and HAZ, use of nevirapine-based regimen rather than efavirenz, and larger CD4% gains to week 48 as predictors of growth reversal after initiating ARV [32].…”

Section: Discussionmentioning

confidence: 35%

“…Nachman et al [28] reported a faster weight gain in children with higher baseline viral load counts. Baseline growth parameters in our cohort were worse than reported from the United States [28,29] and Spain [30] but similar to those reported from Thailand [10] and India [31].…”

Section: Discussionmentioning

confidence: 99%

Clinical manifestations and treatment outcomes in HIV-1-infected children receiving antiretroviral therapy in Karachi, Pakistan

Mir

Qamar

Baig‐Ansari

et al. 2014

J Infect Dev Ctries

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Introduction: The impact of antiretroviral (ARV) therapy on immunological and growth parameters in HIV-positive children in Pakistan has not been reported to date. Methodology: A retrospective chart review of children diagnosed with HIV at the Sindh AIDS Control Proigramme (SACP) and registered at the Aga Khan University, Karachi, between January 2005 and 2013 was conducted, evaluating clinical and laboratory profiles of HIV+ ARV+ children for ARV impact (serial height and weight CD4 and viral counts). Results: Twenty-four children were diagnosed and registered as HIV positive over five years, and 20 were started on ARV. Six were excluded from analysis (ARV duration < 6 months). Nine (64.3%) of 14 fulfilled WHO criteria for treatment failure at a median duration of 25 weeks (IQR 18-32) on ARV and underwent resistance genotyping. All nine had NNRTI resistance, two had high-grade NRTI resistance (≥ 4 thymidine analog mutations). Median age at start of ARV was 71.5 weeks (IQR 37.5-119). Median baseline weight for age (WAZ) and height for age (HAZ) z-scores changed from -1.94 to 1.69 and -1.99 to -1.59, respectively, after six months of therapy. Median CD4 percentage and viral load at baseline changed from 13.8 to 17.8, while viral load changed from 285 × 10 4 copies to zero at six months. Conclusions: ARV improved absolute CD4 and viral counts. Weight and height did not improve significantly, highlighting the need for aggressive nutritional rehabilitation. Early development of ARV resistance in these children requires formal assessment.

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Growth of Human Immunodeficiency Virus-Infected Children Receiving Highly Active Antiretroviral Therapy

Abstract: HAART improved the average weight gain of HIV-infected children from subnormal to normal after 1 year and improved average height growth to nearly normal after 2 years.

Cited by 87 publications

References 19 publications

Síndrome da lipodistrofia e fatores de risco cardiovasculares em crianças e adolescentes infectados pelo HIV/AIDS em uso de terapia antirretroviral de alta potência

Síndrome da lipodistrofia e fatores de risco cardiovasculares em crianças e adolescentes infectados pelo HIV/AIDS em uso de terapia antirretroviral de alta potência

Reversal of Growth Failure in HIV-Infected Thai Children Treated with Non-Nucleoside Reverse Transcriptase Inhibitor–Based Antiretroviral Therapy

Clinical manifestations and treatment outcomes in HIV-1-infected children receiving antiretroviral therapy in Karachi, Pakistan

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