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Home >> Publications >> Early Height and Weight Changes in Children Using Cotrimoxazole Prophylaxis With Antiretroviral Therapy

Publication

Author(s):

Boettiger DC1, Muktiarti D2, Kurniati N2, Truong KH3, Saghayam S4, Ly PS5, Hansudewechakul R6, Van Nguyen L7, Do VC8, Sudjaritruk T9, Lumbiganon P10, Chokephaibulkit K11, Bunupuradah T12, Nik Yusoff NK13, Wati DK14, Mohd Razali KA15, Fong MS16, Nallusamy RA17, Sohn AH18, Kariminia A1; Therapeutics Research, Education, and AIDS Training in Asia (TREAT Asia) Pediatric HIV Observational Database.

Pub Title:

Early Height and Weight Changes in Children Using Cotrimoxazole Prophylaxis With Antiretroviral Therapy

Pub Date:

Nov 1 2016

Pub Region(s):

Asia-Pacific

Journal:

Title: 
Clin Infect Dis.

PubMed: 27470239
Pub PDF:

BACKGROUND: The growth benefits of cotrimoxazole during early antiretroviral therapy (ART) are not well characterized.

METHODS: Individuals enrolled in the Therapeutics Research, Education, and AIDS Training in Asia Pediatric HIV Observational Database were included if they started ART at ages 1 month-14 years and had both height and weight measurements available at ART initiation (baseline). Generalized estimating equations were used to identify factors associated with change in height-for-age z-score (HAZ), follow-up HAZ ≥ -2, change in weight-for-age z-score (WAZ), and follow-up WAZ ≥ -2.

RESULTS: A total of 3217 children were eligible for analysis. The adjusted mean change in HAZ among cotrimoxazole and non-cotrimoxazole users did not differ significantly over the first 24 months of ART. In children who were stunted (HAZ < -2) at baseline, cotrimoxazole use was not associated with a follow-up HAZ ≥ -2. The adjusted mean change in WAZ among children with a baseline CD4 percentage (CD4%) >25% became significantly different between cotrimoxazole and non-cotrimoxazole users after 6 months of ART and remained significant after 24 months (overall P < .01). Similar changes in WAZ were observed in those with a baseline CD4% between 10% and 24% (overall P < .01). Cotrimoxazole use was not associated with a significant difference in follow-up WAZ in children with a baseline CD4% <10%. In those underweight (WAZ < -2) at baseline, cotrimoxazole use was associated with a follow-up WAZ ≥ -2 (adjusted odds ratio, 1.70 vs not using cotrimoxazole [95% confidence interval, 1.28-2.25], P < .01). This association was driven by children with a baseline CD4% ≥10%.

CONCLUSIONS; Cotrimoxazole use is associated with benefits to WAZ but not HAZ during early ART in Asian children.

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Citation:

Clin Infect Dis. 2016 Nov 1;63(9):1236-1244. Epub 2016 Jul 28. Early Height and Weight Changes in Children Using Cotrimoxazole Prophylaxis With Antiretroviral Therapy. Boettiger DC1, Muktiarti D2, Kurniati N2, Truong KH3, Saghayam S4, Ly PS5, Hansudewechakul R6, Van Nguyen L7, Do VC8, Sudjaritruk T9, Lumbiganon P10, Chokephaibulkit K11, Bunupuradah T12, Nik Yusoff NK13, Wati DK14, Mohd Razali KA15, Fong MS16, Nallusamy RA17, Sohn AH18, Kariminia A1; Therapeutics Research, Education, and AIDS Training in Asia (TREAT Asia) Pediatric HIV Observational Database.