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Home >> Publications >> Growth response to antiretroviral treatment in HIV-infected children: a cohort study from Lilongwe, Malawi.

Publication

Author(s):

Weigel R, Phiri S, Chiputula F, Gumulira J, Brinkhof M, Gsponer T, Tweya H, Egger M, Keiser O.

Pub Title:

Growth response to antiretroviral treatment in HIV-infected children: a cohort study from Lilongwe, Malawi.

Pub Date:

Aug 31 2010

Pub Region(s):

Southern Africa

Journal Issue:

8

Page Number:
934-44

Journal:

Title: 
Tropical Medicine and International Health
Link: 
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2010.02561.x/abstract

PubMed: 20561308
Pub PDF: PDF icon 20561308.pdf

Abstract
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.

PMID: 20561308 [PubMed - indexed for MEDLINE]

 

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Citation:

Weigel R, Phiri S, Chiputula F, Gumulira J, Brinkhof M, Gsponer T, Tweya H, Egger M, Keiser O. Growth response to antiretroviral treatment in HIV-infected children: a cohort study from Lilongwe, Malawi. Trop Med Int Health. 2010 Aug;15(8):934-44. doi: 10.1111/j.1365-3156.2010.02561.x. Epub 2010 Jun 15. PubMed PMID: 20561308.