OBJECTIVE: To determine the effect of protease inhibitors (PIs) on growth and body composition in children with human immunodeficiency virus type 1 (HIV-1) infection. BACKGROUND: HIV-1-infected children have chronic problems with both linear growth and weight gain. Viral load may directly influence growth and nutritional status of HIV-1-infected children with reduction of viral load improving the nutritional condition. DESIGN/ METHODS: Data from 67 patients who initiated PI therapy between 1996 and 1999 and who were enrolled in a prospective, longitudinal study of growth and nutrition in HIV-1-infected children were analyzed. Outcomes included pre-PI versus post-PI measures of height, weight, weight-for-height, triceps skinfold thickness, and arm muscle circumference. Predictor covariates included age, race, gender, Tanner stage, CD4 z score, Centers for Disease Control and Prevention stage, route of infection, plasma HIV-1 RNA, other antiretroviral therapy, recommended daily allowances for calories, treatment with megestrol acetate, and PI therapy. RESULTS: Sixty-seven children were followed for a median of 2.4 years with a total of 362 visits (median: 5 visits; range: 1-12). During follow-up, they received PIs for a median of 5 months. Fifty-one percent were girls, 54% black, 15% Hispanic, and 25% white. The mean age at first visit was 6.8 years. In a univariate analysis, weight z score (-0.67 to -0.35) and weight/height z score (0.25-0.76) improved on PI therapy. Using repeated-measures regression analysis, controlling for the above named covariates, PI treatment showed a significant effect on weight z score (increase in z score by 0.46), weight/height z score (increase in z score by 0.49), and arm muscle circumference (increase in percentile by 11.5). A borderline effect was found for height z score (increase in z score by 0.17) and no effect was found for triceps skinfold thickness. In a separate analysis, PI therapy increased CD4 counts twofold and reduced plasma HIV-1 RNA copies by 79%. CONCLUSION: In addition to a significant reduction in viral load, PI therapy in children has a positive effect on several growth parameters, including weight, weight/height, and muscle mass.
OBJECTIVE: To determine the effect of protease inhibitors (PIs) on growth and body composition in children with human immunodeficiency virus type 1 (HIV-1) infection. BACKGROUND:HIV-1-infectedchildren have chronic problems with both linear growth and weight gain. Viral load may directly influence growth and nutritional status of HIV-1-infectedchildren with reduction of viral load improving the nutritional condition. DESIGN/ METHODS: Data from 67 patients who initiated PI therapy between 1996 and 1999 and who were enrolled in a prospective, longitudinal study of growth and nutrition in HIV-1-infectedchildren were analyzed. Outcomes included pre-PI versus post-PI measures of height, weight, weight-for-height, triceps skinfold thickness, and arm muscle circumference. Predictor covariates included age, race, gender, Tanner stage, CD4 z score, Centers for Disease Control and Prevention stage, route of infection, plasma HIV-1 RNA, other antiretroviral therapy, recommended daily allowances for calories, treatment with megestrol acetate, and PI therapy. RESULTS: Sixty-seven children were followed for a median of 2.4 years with a total of 362 visits (median: 5 visits; range: 1-12). During follow-up, they received PIs for a median of 5 months. Fifty-one percent were girls, 54% black, 15% Hispanic, and 25% white. The mean age at first visit was 6.8 years. In a univariate analysis, weight z score (-0.67 to -0.35) and weight/height z score (0.25-0.76) improved on PI therapy. Using repeated-measures regression analysis, controlling for the above named covariates, PI treatment showed a significant effect on weight z score (increase in z score by 0.46), weight/height z score (increase in z score by 0.49), and arm muscle circumference (increase in percentile by 11.5). A borderline effect was found for height z score (increase in z score by 0.17) and no effect was found for triceps skinfold thickness. In a separate analysis, PI therapy increased CD4 counts twofold and reduced plasma HIV-1 RNA copies by 79%. CONCLUSION: In addition to a significant reduction in viral load, PI therapy in children has a positive effect on several growth parameters, including weight, weight/height, and muscle mass.
Authors: Tracie L Miller; Gabriel Somarriba; E John Orav; Armando J Mendez; Daniela Neri; Natasha Schaefer; Lourdes Forster; Ronald Goldberg; Gwendolyn B Scott; Steven E Lipshultz Journal: J Acquir Immune Defic Syndr Date: 2010-10 Impact factor: 3.731
Authors: Denise L Jacobson; Kunjal Patel; George K Siberry; Russell B Van Dyke; Linda A DiMeglio; Mitchell E Geffner; Janet S Chen; Elizabeth J McFarland; William Borkowsky; Margarita Silio; Roger A Fielding; Suzanne Siminski; Tracie L Miller Journal: Am J Clin Nutr Date: 2011-11-02 Impact factor: 7.045
Authors: Tracie L Miller; Carlo Agostoni; Christopher Duggan; Alfredo Guarino; Mark Manary; Carlos A Velasco Journal: J Pediatr Gastroenterol Nutr Date: 2008-08 Impact factor: 2.839