BACKGROUND: Poor growth is an indication for antiretroviral therapy (ART) and a criterion for treatment failure. We examined variability in growth response to ART in 12 programs in Malawi, Zambia, Zimbabwe, Mozambique, and South Africa. METHODS: Treatment naïve children aged <10 years were included. We calculated weight for age z scores (WAZs), height for age z scores (HAZs), and weight for height z scores (WHZs) up to 3 years after starting ART, by using the World Health Organization standards. Multilevel regression models were used. RESULTS: A total of 17990 children (range, 238-8975) were followed for 36181 person-years. At ART initiation, most children were underweight (50%) and stunted (66%). Lower baseline WAZ, HAZ, and WHZ were the most important determinants of faster catch-up growth on ART. WAZ and WHZ increased rapidly in the first year and stagnated or reversed thereafter, whereas HAZ increased continuously over time. Three years after starting ART, WAZ ranged from -2.80 (95% confidence interval [CI]: -3.66 to -2.02) to -1.98 (95% CI: -2.41 to -1.48) in children with a baseline z score < -3 and from -0.79 (95% CI: -1.62 to 0.02) to 0.05 (95% CI: -0.42 to 0.51) in children with a baseline WAZ ≥ -1. For HAZ, the corresponding range was -2.33 (95% CI: -2.62 to -2.02) to -1.27 (95% CI: -1.58 to -1.00) for baseline HAZ < -3 and -0.24 (95% CI: -0.56 to 0.15) to 0.84 (95% CI: 0.53 to 1.16) for HAZ ≥ -1. CONCLUSIONS: Despite a sustained growth response and catch-up growth in children with advanced HIV disease treated with ART, normal weights and heights are not achieved over 3 years of ART.
BACKGROUND: Poor growth is an indication for antiretroviral therapy (ART) and a criterion for treatment failure. We examined variability in growth response to ART in 12 programs in Malawi, Zambia, Zimbabwe, Mozambique, and South Africa. METHODS: Treatment naïve children aged <10 years were included. We calculated weight for age z scores (WAZs), height for age z scores (HAZs), and weight for height z scores (WHZs) up to 3 years after starting ART, by using the World Health Organization standards. Multilevel regression models were used. RESULTS: A total of 17990 children (range, 238-8975) were followed for 36181 person-years. At ART initiation, most children were underweight (50%) and stunted (66%). Lower baseline WAZ, HAZ, and WHZ were the most important determinants of faster catch-up growth on ART. WAZ and WHZ increased rapidly in the first year and stagnated or reversed thereafter, whereas HAZ increased continuously over time. Three years after starting ART, WAZ ranged from -2.80 (95% confidence interval [CI]: -3.66 to -2.02) to -1.98 (95% CI: -2.41 to -1.48) in children with a baseline z score < -3 and from -0.79 (95% CI: -1.62 to 0.02) to 0.05 (95% CI: -0.42 to 0.51) in children with a baseline WAZ ≥ -1. For HAZ, the corresponding range was -2.33 (95% CI: -2.62 to -2.02) to -1.27 (95% CI: -1.58 to -1.00) for baseline HAZ < -3 and -0.24 (95% CI: -0.56 to 0.15) to 0.84 (95% CI: 0.53 to 1.16) for HAZ ≥ -1. CONCLUSIONS: Despite a sustained growth response and catch-up growth in children with advanced HIV disease treated with ART, normal weights and heights are not achieved over 3 years of ART.
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
Authors: Carolyn Bolton-Moore; Mwangelwa Mubiana-Mbewe; Ronald A Cantrell; Namwinga Chintu; Elizabeth M Stringer; Benjamin H Chi; Moses Sinkala; Chipepo Kankasa; Craig M Wilson; Catherine M Wilfert; Albert Mwango; Jens Levy; Elaine J Abrams; Marc Bulterys; Jeffrey S A Stringer Journal: JAMA Date: 2007-10-24 Impact factor: 56.272
Authors: Mark M Kabue; Adeodata Kekitiinwa; Albert Maganda; Jan M Risser; Wenyaw Chan; Mark W Kline Journal: AIDS Patient Care STDS Date: 2008-03 Impact factor: 5.078
Authors: Catherine G Sutcliffe; Janneke H van Dijk; Bornface Munsanje; Francis Hamangaba; Pamela Sinywimaanzi; Philip E Thuma; William J Moss Journal: BMC Infect Dis Date: 2011-03-01 Impact factor: 3.090
Authors: Anand Reddi; Sarah C Leeper; Anneke C Grobler; Rosemary Geddes; K Holly France; Gillian L Dorse; Willem J Vlok; Mbali Mntambo; Monty Thomas; Kristy Nixon; Helga L Holst; Quarraisha Abdool Karim; Nigel C Rollins; Hoosen M Coovadia; Janet Giddy Journal: BMC Pediatr Date: 2007-03-17 Impact factor: 2.125
Authors: Luisa Salazar-Vizcaya; Olivia Keiser; Mary-Ann Davies; Andreas D Haas; Nello Blaser; Vivian Cox; Brian Eley; Helena Rabie; Harry Moultrie; Janet Giddy; Robin Wood; Matthias Egger; Janne Estill Journal: AIDS Date: 2014-10-23 Impact factor: 4.177
Authors: Ramadhani S Mwiru; Donna Spiegelman; Christopher Duggan; George R Seage; Helen Semu; Guerino Chalamilla; Rodrick Kisenge; Wafaie W Fawzi Journal: J Trop Pediatr Date: 2014-01-06 Impact factor: 1.165
Authors: Tin Tin Sint; Ronnie Lovich; Wendy Hammond; Maria Kim; Sara Melillo; Lydia Lu; Pamela Ching; Jennifer Marcy; Nigel Rollins; Emilia H Koumans; Amie N Heap; Margaret Brewinski-Isaacs Journal: AIDS Date: 2013-11 Impact factor: 4.177