Natural history of somatic growth in infants born to women infected by human immunodeficiency virus

Moye, John; Rich, Kenneth; Kalish, Leslie A.; Sheon, Amy R.; Díaz, Clemente; Cooper, Ellen; Pitt, Jane; Handelsman, Edward

doi:10.1016/s0022-3476(96)70428-6

Cited by 136 publications

(93 citation statements)

References 29 publications

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“…26,27 Reports from Africa initially called HIV-1 the "slim disease." 28 Although several reports have characterized growth patterns for HIV-1-infected children, [1][2][3][4][5] few have reported important both prenatal and postnatal clinical or biochemical associates of growth problems. 29 Simple longitudinal analyses of weight and length or height have shown that stable HIV-1-infected children experience a nearly proportionate decline in both length or height and weight but maintain nearly normal ratios of weight for length or height.…”

Section: Discussionmentioning

confidence: 99%

“…29 Simple longitudinal analyses of weight and length or height have shown that stable HIV-1-infected children experience a nearly proportionate decline in both length or height and weight but maintain nearly normal ratios of weight for length or height. [2][3][4][5] As children become sicker, wasting becomes more clinically obvious. By controlling for the multiple potential confounders that can affect growth, some studies, including the Women and Infants Transmission Study, showed that HIV-1 itself influences both height and weight.…”

Section: Discussionmentioning

confidence: 99%

“…By controlling for the multiple potential confounders that can affect growth, some studies, including the Women and Infants Transmission Study, showed that HIV-1 itself influences both height and weight. 4 In the Women and Infants Transmission Study, maternal and neonatal factors were evaluated only at baseline, yet the authors recognized the importance of evaluating postnatal events.…”

Section: Discussionmentioning

confidence: 99%

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Maternal and Infant Factors Associated With Failure to Thrive in Children With Vertically Transmitted Human Immunodeficiency Virus-1 Infection: The Prospective, P2C2 Human Immunodeficiency Virus Multicenter Study

et al. 2001

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Objective-Many children with human immunodeficiency virus-1 (HIV-1) have chronic problems with growth and nutrition, yet limited information is available to identify infected children at high risk for growth abnormalities. Using data from the prospective, multicenter P 2 C 2 HIV study, we evaluated the relationships between maternal and infant clinical and laboratory factors and impaired growth in this cohort.Methods-Children of HIV-1-infected women were enrolled prenatally or within the first 28 days of life. Failure to thrive (FTT) was defined as an age-and sex-adjusted weight z score ≤−2.0 SD. Maternal baseline covariates included age, race, illicit drug use, zidovudine use, CD4 + T-cell count, and smoking. Infant baseline predictors included sex, race, CD4 + T-cell count, Centers for Disease Control stage, HIV-1 RNA, antiretroviral therapy, pneumonia, heart rate, cytomegalovirus, and Epstein-Barr virus infection status.Results-The study cohort included 92 HIV-1-infected and 439 uninfected children. Infected children had a lower mean gestational age, but birth weights, lengths, and head circumferences in the 2 groups were similar. Mothers of growth-delayed infants were more likely to have smoked Copyright © 2001 by the American Academy of Pediatrics. Reprint requests to (T.L.M.) Division of Pediatric Gastroenterology and Nutrition, Box 667, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642. tracie_miller@urmc.rochester.edu. National Heart, Lung, and Blood Institute, Bethesda, MD The institutions and investigators participating in this study are listed in the "Appendix." HHS Public Access Author manuscriptPediatrics. Author manuscript; available in PMC 2015 April 03. Published in final edited form as:Pediatrics. 2001 December ; 108(6): 1287-1296. Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript tobacco and used illicit drugs during pregnancy. In repeated-measures analyses of weight and length or height z scores, the means of the HIV-1-infected group were significantly lower at 6 months of age (P < .001) and remained lower throughout the first 5 years of life. Conclusion-Clinical and laboratory factors associated with FTT among HIV-1-infected children include history of pneumonia, maternal illicit drug use during pregnancy, lower infant CD4 + T-cell count, exposure to antiretroviral therapy by 3 months of age (non-protease inhibitor), and HIV-1 RNA viral load. Keywordshuman immunodeficiency virus; children; failure to thrive; growth; malnutrition Many children with human immunodeficiency virus-1 (HIV-1) infection have chronic problems with linear growth and weight gain. 1-5 A variety of disturbed growth patterns have been described, ranging from symmetric delays in weight and length or height to severe wasting with normal length or height. The differences in growth patterns probably result from differences in disease manifestations in HIV-1-infected children. In developed countries, both weight and length or height decline in infected children as early as...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Maternal and Infant Factors Associated With Failure to Thrive in Children With Vertically Transmitted Human Immunodeficiency Virus-1 Infection: The Prospective, P2C2 Human Immunodeficiency Virus Multicenter Study

et al. 2001

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“…to emerge during their fi rst few months of life. 9,16,17 A cohort study that was conducted in Belo Horizonte, Southeastern Brazil, revealed that the decrease in growth in weight, but not in length, in HIV-infected children in Brazil was larger than that reported in a European cohort, which likely refl ects background nutritional defi ciencies and co-infections. 9 The assessment of growth in HIV-infected children is important to determine the disease stage and prognosis, to assess the effectiveness and toxicity of antiretroviral therapies and to study the nutritional implications of the HIV infection.…”

Section: Resultsmentioning

confidence: 99%

Longitudinal anthropometric assessment of infants born to HIV-1-infected mothers, Belo Horizonte, Southeastern Brazil

et al. 2011

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OBJECTIVE:To evaluate the growth parameters in infants who were born to HIV-1-infected mothers. METHODS:The study was a longitudinal evaluation of the z-scores for the weight-for-age (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) data collected from a cohort. A total of 97 non-infected and 33 HIV-infected infants born to HIV-1-infected mothers in Belo Horizonte, Southeastern Brazil, between 1995 and 2003 was studied. The average follow-up period for the infected and non-infected children was 15.8 months (variation: 6.8 to 18.0 months) and 14.3 months (variation: 6.3 to 18.6 months), respectively. A mixed-effects linear regression model was used and was fi tted using a restricted maximum likelihood. RESULTS:There was an observed decrease over time in the WAZ, LAZ and WLZ among the infected infants. At six months of age, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.02, 0.59, and 0.63 standard deviations, respectively. At 12 months, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.15, 1.01, and 0.87 standard deviations, respectively. CONCLUSIONS:The precocious and increasing deterioration of the HIVinfected infants' anthropometric indicators demonstrates the importance of the early identifi cation of HIV-infected infants who are at nutritional risk and the importance of the continuous assessment of nutritional interventions for these infants.

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“…28,33,34 Deficits in growth are common in HIVinfected children, and growth failure has been associated with elevated viral load. [35][36][37] In hemophiliac boys, HIV-infected children with abnormal growth were found to have a significantly lower bone age than HIV-infected hemophiliacs without growth abnormalities and to have reduced androgen and growth hormone production compared with noninfected hemophiliacs. 38 Deficits in bone mineral mass and calcitropic hormones were described in a study of young girls with perinatal HIV infection.…”

Section: Discussionmentioning

confidence: 99%

Osteonecrosis of the Hip (Legg-Calvé-Perthes Disease) in Human Immunodeficiency Virus-Infected Children

et al. 2002

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ABSTRACT. Objective. Osteonecrosis of the hip has been reported in human immunodeficiency virus (HIV)-infected adults; whether this is related to HIV infection or its treatment is unknown. There has been 1 report of osteonecrosis among HIV-infected children. Specifically, avascular necrosis of the hip consistent with Legg-Calvé-Perthes disease (LCPD) was reported in 3 HIV-infected children with AIDS from Spain in 1992. We evaluated the prevalence and incidence of LCPD, the pediatric equivalent of adult osteonecrosis of the hip, in HIV-infected children participating in a prospective cohort study of long-term outcomes in HIV-infected and HIV-exposed children-Pediatric AIDS Clinical Trials Group (PACTG) protocol 219.Methods. PACTG 219 enrolled 2014 HIV-infected and 849 HIV-exposed, uninfected children between April 1993 and September 2000. Children had periodic examinations with collection of clinical and laboratory data. The database was reviewed for reports of LCPD and other bone disorders. A prevalent case was defined as LCPD diagnosis preceding PACTG 219 enrollment and an incident case had to have occurred between enrollment and September 2000. A case-control study (matching on age, gender, and race/ethnicity, which are known to be associated with risk of LCPD and HIV infection status) was performed to investigate factors possibly associated with LCPD.Results. Six cases of LCPD (4 prevalent cases reported at study entry; 2 diagnosed during 5837 person-years of follow-up) were observed; LCPD was seen only in children with perinatal HIV infection. LCPD prevalence was 199 per 100 000 compared with an estimated general pediatric population prevalence of 23 per 100 000. Based on age-adjusted general population rates, the expected number of prevalent cases at PACTG 219 study entry would have been 0.44; the age-adjusted LCPD prevalence rate ratio was 9.0 (95% confidence interval [CI]: 8.3-9.7) for HIV-infected children compared with the general population. LCPD incidence was 34 per 100 000 person-years (95% CI: 0.42-124) compared with the estimated general population incidence of 6 per 100 000 person-years (95% CI: 5-7). Based on age-adjusted general population rates, the expected incidence of LCPD in PACTG 219 would have been 0.42; the age-adjusted relative risk of LCPD in HIV-infected PACTG 219 children was 4.8 (95% CI: 0.56 -10.4). No cases were observed in uninfected children during 1919 person-years of follow-up on PACTG 219; the age-adjusted expected number of cases was 0.09. Median onset age was 7 years; 67% were of Hispanic or black race/ethnicity and 33% were female. Four of the 6 LCPD cases had received antiretroviral therapy before diagnosis; treatment was primarily with nucleoside reverse transcriptase inhibitors, and 2 had received protease inhibitors. Three of the LCPD cases had corticosteroid exposure before the diagnosis, but only 1 child had systemic exposure and the remaining 2 had topical exposure exclusively. In the case-control study, antiretroviral and corticosteroid therapy, CD4 cell percentage...

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Natural history of somatic growth in infants born to women infected by human immunodeficiency virus

Cited by 136 publications

References 29 publications

Maternal and Infant Factors Associated With Failure to Thrive in Children With Vertically Transmitted Human Immunodeficiency Virus-1 Infection: The Prospective, P2C2 Human Immunodeficiency Virus Multicenter Study

Maternal and Infant Factors Associated With Failure to Thrive in Children With Vertically Transmitted Human Immunodeficiency Virus-1 Infection: The Prospective, P2C2 Human Immunodeficiency Virus Multicenter Study

Longitudinal anthropometric assessment of infants born to HIV-1-infected mothers, Belo Horizonte, Southeastern Brazil

Osteonecrosis of the Hip (Legg-Calvé-Perthes Disease) in Human Immunodeficiency Virus-Infected Children

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