Impact of HAART on growth and hospitalization rates among HIV-infected children

Diniz, Lílian Martins Oliveira; Maia, Marcelle Marie Martins; Camargos, Let&iacute;cia Silveira; Amaral, Leandro Cust&oacute;dio; Goulart, Eug&ecirc;nio Marcos Andrade; Pinto, Jorge

doi:10.2223/jped.2064

Cited by 6 publications

(7 citation statements)

References 21 publications

(39 reference statements)

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“…This research finding also disclosed comparable weight recovery between the two wings of treatment category at three and six months of ART which is also in compatible with other research findings (Abebe, 2017). Weight gain of greater than 10% at six months of ART was demonstrated in 44% of the patients in our study which was in consistence with the study from Brazil which showed mean weight-for-age z scores increment from -1.62 (±1.32) at baseline to -1.14 (±1.12) weight-for-age z scores at week 24 (Diniz, 2011).…”

Section: Discussionsupporting

confidence: 90%

Immunological outcomes of neverapin (NVP) versus efafrenz (EFV) based antiretroviral therapy (ART) regimen among children on ART: A study from Black Lion Hospital, Addis Ababa, Ethiopia

Sorsa¹

2018

J. Infect. Dis. Immun.

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Antiretroviral therapy has reduced HIV-related morbidity and mortality substantially. WHO recommends the use of Nevirapine or Efavirenz as first line combined with two from nucleoside reverse transcriptase inhibitors. In this study the immunological outcomes of Neverapin versus Efafrenz based ART was assessed. Medical records of patients were retrieved and important variables were captured to standard questionnaire. Medical records of 120 patients from NVP-based regimen and 60 patients from EFV groups were revised. The CD4 cell count at the start of HAART ranged from 3-2003 cell/ml with an inter quartile range (IQR) of 231-317 cell/ml among NVP group. And among patients taking EFV based ART regimen, baseline CD4 count ranged 13-2095 cell/ml with an IQR range of 250-345 cell/ml. After six months of HAART, the CD4 cell count of NVP based regimen range from 71-2300 c/ml with IQR of 458-612 c/ml, and mean CD4 cell count difference of 215, 95% CI (175.414-245.613). From EFV based group, CD4 count ranged from 65-2100 c/ml with IQR of 435-605 c/ml, and the mean CD4 cell count difference of 205, 95% CI (155.404-235.623). The immunological recovery was found to be comparable among the two groups. Advanced clinical stage of the disease, severe immune suppression, presence of anemia, presence of chronic diarrhea , poor weight gain during first six months of ART were adversely affected the trends of CD4 recovery. This research report demonstrated that immunological outcomes were comparable among patient taking NVP vs EFV based ART regimen.

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Section: Discussionsupporting

confidence: 90%

Immunological outcomes of neverapin (NVP) versus efafrenz (EFV) based antiretroviral therapy (ART) regimen among children on ART: A study from Black Lion Hospital, Addis Ababa, Ethiopia

Sorsa¹

2018

J. Infect. Dis. Immun.

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“…Age at ART initiation impacted on growth improvement: Children older than 3 years experienced a lower weight and height increase than younger children, and this resulted in better BMI outcome in infants, while height outcomes did not differ across age groups. Previous studies consistently describe improved weight outcomes for younger children [16,18,21,22,24,26,[35][36][37][38], possibly related to less severe gastrointestinal impairment and shorter duration of chronic immune activation [39,40]. Reports on the impact of age on height differ between studies, with improved height outcomes with younger age in some studies [23,24,26,35], while others reported no difference [36] or worse height outcomes for younger children [20,22].…”

Section: Discussionmentioning

confidence: 97%

“…ART has a positive effect on weight and, to a lesser extent, on height growth . As opposed to studies from developed countries [10,11,27], reports from developing countries have not shown normalisation of growth parameters [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. These studies, however, generally had relatively short follow-up periods of up to 2 years and were hampered by substantial loss to follow-up.…”

Section: Introductionmentioning

confidence: 99%

Growth in HIV‐infected children on long‐term antiretroviral therapy

Feucht

Bruwaene

Becker

et al. 2016

Tropical Med Int Health

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Abstractobjectives To describe growth in HIV-infected children on long-term antiretroviral therapy (ART) and to assess social, clinical, immunological and virological factors associated with suboptimal growth.methods This observational cohort study included all HIV-infected children at an urban ART site in South Africa who were younger than 5 years at ART initiation and with more than 5 years of follow-up. Growth was assessed using weight-for-age Z-scores (WAZ), height-for-age Zscores (HAZ) and body mass index (BMI)-for-age Z-scores (BAZ). Children were stratified according to pre-treatment anthropometry and age. Univariate and mixed linear analysis were used to determine associations between independent variables and weight and height outcomes.results The majority of the 159 children presented with advanced clinical disease (90%) and immunosuppression (89%). Before treatment underweight, stunting and wasting were common (WAZ<À2 = 50%, HAZ<À2 = 73%, BAZ<À2 = 19%). Weight and BMI improved during the initial 12 months, while height improved over the entire 5-year period. Height at study exit was significantly worse for children with growth impairment at ART initiation (P < 0.001), and infants (<1 year) demonstrated superior improvement in terms of BMI (P = 0.04). Tuberculosis was an independent risk factor for suboptimal weight (P = 0.01) and height (P = 0.02) improvement. Weight gain was also hindered by lack of electricity (P = 0.04). Immune reconstitution and virological suppression were not associated with being underweight or stunted at study endpoint.

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“…In another Thai study, (5,11) the incidence of hospitalization was found to be 30.7% in the first six months of life, declining to 2.0% by the third year of life. A Brazilian study (6,12) found that 43.3% of children were hospitalized in the first three years of therapy. Although investigators have looked into the patterns and causes of hospitalization in children, there are little or no published studies investigating predictors of hospitalization in children on HAART.…”

Section: Introductionmentioning

confidence: 99%

Predictors of hospitalization among children on ART in Ethiopia: A cohort study

Haileamlak¹,

Hagos²,

Abebe³

et al. 2017

Ethiop J Health Sci

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Background: Substantial progress has been made in the management of pediatric HIV infection in Ethiopia with the implementation of mother-to-child-prevention programs. Since the introduction of HAART in 2005, mortality among HIV-infected children has reduced while the rate of hospitalization was expected to rise. The purpose of this study, therefore, was to assess predictors of hospitalization in children on ART in seven university referral hospitals in Ethiopia. Methods: A prospective cohort study design was employed on children age 0-18 years as part of a multisite observational study. ART-experienced eligible and ART-naïve children with HIV/AIDS were enrolled into the Advanced Clinical Monitoring (ACM) till December 31, 2012 were included. From the database, information on hospitalization and other independent variables were extracted. Analysis was done using both SPSS for Windows version 16.0 and STATA. Descriptive analyses and modeling was done using logistic regression. Results: Of the 405 children on ART (174 experienced, 231 naive), 86 (20.7%) were hospitalized for various reasons; two children were excluded since they were hospitalized for unrelated conditions (appendicitis and burn). Fifty one (60.7%) of the eighty four admitted children were hospitalized in the first six months of ART initiation. Of the independent variables, only the presence of opportunistic infections and duration on ART were significantly associated with hospitalization both on bi-variable and multivariable analyses (P-value <0.05). As the duration on ART increased by one month, the risk of hospitalization decreased by 5.4%, which is statistically significant (P < 0.001). Whereas the incidence (number) of OI's increased by one, the risk of being hospitalized increased by 35.2% (P = 0.002). Of the individual opportunistic infections, pneumonia was found to be the only predictor of hospitalization (P-value = 0.002). Conclusion: This study showed that nearly two-third of the hospitalization was within 6 months of initiation of ART; and presence of OI and duration on ART were the only predictors of hospitalization.

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Impact of HAART on growth and hospitalization rates among HIV-infected children

Cited by 6 publications

References 21 publications

Immunological outcomes of neverapin (NVP) versus efafrenz (EFV) based antiretroviral therapy (ART) regimen among children on ART: A study from Black Lion Hospital, Addis Ababa, Ethiopia

Immunological outcomes of neverapin (NVP) versus efafrenz (EFV) based antiretroviral therapy (ART) regimen among children on ART: A study from Black Lion Hospital, Addis Ababa, Ethiopia

Growth in HIV‐infected children on long‐term antiretroviral therapy

Predictors of hospitalization among children on ART in Ethiopia: A cohort study

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