OBJECTIVE: Malnutrition is common in HIV-infected children in Africa and an indication for antiretroviral treatment (ART). We examined anthropometric status and response to ART in children treated at a large public-sector clinic in Malawi. METHODS: All children aged <15 years who started ART between January 2001 and December 2006 were included and followed until March 2008. Weight and height were measured at regular intervals from 1 year before to 2 years after the start of ART. Sex- and age-standardized z-scores were calculated for weight-for-age (WAZ) and height-for-age (HAZ). Predictors of growth were identified in multivariable mixed-effect models. RESULTS: A total of 497 children started ART and were followed for 972 person-years. Median age (interquartile range; IQR) was 8 years (4-11 years). Most children were underweight (52% of children), stunted (69%), in advanced clinical stages (94% in WHO stages 3 or 4) and had severe immunodeficiency (77%). After starting ART, median (IQR) WAZ and HAZ increased from -2.1 (-2.7 to -1.3) and -2.6 (-3.6 to -1.8) to -1.4 (-2.1 to -0.8) and -1.8 (-2.4 to -1.1) at 24 months, respectively (P < 0.001). In multivariable models, baseline WAZ and HAZ scores were the most important determinants of growth trajectories on ART. CONCLUSIONS: Despite a sustained growth response to ART among children remaining on therapy, normal values were not reached. Interventions leading to earlier HIV diagnosis and initiation of treatment could improve growth response.
OBJECTIVE:Malnutrition is common in HIV-infectedchildren in Africa and an indication for antiretroviral treatment (ART). We examined anthropometric status and response to ART in children treated at a large public-sector clinic in Malawi. METHODS: All children aged <15 years who started ART between January 2001 and December 2006 were included and followed until March 2008. Weight and height were measured at regular intervals from 1 year before to 2 years after the start of ART. Sex- and age-standardized z-scores were calculated for weight-for-age (WAZ) and height-for-age (HAZ). Predictors of growth were identified in multivariable mixed-effect models. RESULTS: A total of 497 children started ART and were followed for 972 person-years. Median age (interquartile range; IQR) was 8 years (4-11 years). Most children were underweight (52% of children), stunted (69%), in advanced clinical stages (94% in WHO stages 3 or 4) and had severe immunodeficiency (77%). After starting ART, median (IQR) WAZ and HAZ increased from -2.1 (-2.7 to -1.3) and -2.6 (-3.6 to -1.8) to -1.4 (-2.1 to -0.8) and -1.8 (-2.4 to -1.1) at 24 months, respectively (P < 0.001). In multivariable models, baseline WAZ and HAZ scores were the most important determinants of growth trajectories on ART. CONCLUSIONS: Despite a sustained growth response to ART among children remaining on therapy, normal values were not reached. Interventions leading to earlier HIV diagnosis and initiation of treatment could improve growth response.
Authors: Daniel K Benjamin; Steven Hirschfeld; Coleen K Cunningham; Ross E McKinney Journal: J Antimicrob Chemother Date: 2004-09-08 Impact factor: 5.790
Authors: Sharon A Nachman; Jane C Lindsey; Jack Moye; Kenneth E Stanley; George M Johnson; Paul A Krogstad; Andrew A Wiznia Journal: Pediatr Infect Dis J Date: 2005-04 Impact factor: 2.129
Authors: Miriam K Laufer; Joep J G van Oosterhout; M Arantza Perez; Joseph Kanyanganlika; Terrie E Taylor; Christopher V Plowe; Stephen M Graham Journal: Pediatr Infect Dis J Date: 2006-07 Impact factor: 2.129
Authors: Gwenda Verweel; Annemarie M C van Rossum; Nico G Hartwig; Tom F W Wolfs; Henriëtte J Scherpbier; Ronald de Groot Journal: Pediatrics Date: 2002-02 Impact factor: 7.124
Authors: Daniel K Benjamin; Wiliam C Miller; Daniel K Benjamin; Robert W Ryder; David J Weber; Emmanuel Walter; Ross E McKinney Journal: AIDS Date: 2003-11-07 Impact factor: 4.177
Authors: Shirin Heidari; Lynne M Mofenson; Charlotte V Hobbs; Mark F Cotton; Richard Marlink; Elly Katabira Journal: J Acquir Immune Defic Syndr Date: 2012-02-01 Impact factor: 3.731
Authors: Charles K Vorkas; Hannock Tweya; Dalitso Mzinganjira; George Dickie; Ralf Weigel; Sam Phiri; Mina C Hosseinipour Journal: Trop Med Int Health Date: 2011-11-01 Impact factor: 2.622
Authors: Thomas Gsponer; Ralf Weigel; Mary-Ann Davies; Carolyn Bolton; Harry Moultrie; Paula Vaz; Helena Rabie; Karl Technau; James Ndirangu; Brian Eley; Daniela Garone; Maureen Wellington; Janet Giddy; Jochen Ehmer; Matthias Egger; Olivia Keiser Journal: Pediatrics Date: 2012-09-17 Impact factor: 7.124