LOGIN

International Epidemiology Databases to Evaluate AIDS

Home >> Publications >> Variability of growth in children starting antiretroviral treatment in southern Africa.

Publication

Author(s):

Gsponer T, Weigel R, Davies MA, Bolton C, Moultrie H, Vaz P, Rabie H, Technau K, Ndirangu J, Eley B, Garone D, Wellington M, Giddy J, Ehmer J, Egger M, Keiser O; IeDEA Southern Africa Collaboration.

Pub Title:

Variability of growth in children starting antiretroviral treatment in southern Africa.

Pub Date:

Oct 31 2012

Pub Region(s):

Southern Africa

Journal Issue:

4

Page Number:
e966-77

Journal:

Title: 
Pediatrics
Link: 
http://pediatrics.aappublications.org/content/130/4/e966.1.long

PubMed: 22987878
Pub PDF: PDF icon 22987878.pdf

Abstract
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.

PMID: 22987878 [PubMed - indexed for MEDLINE]

PMCID: PMC3457616

 

The following websites provide guidelines and policies when citing from PubMed®: http://www.ncbi.nlm.nih.gov/books/NBK7243/
http://www.nlm.nih.gov/bsd/policy/cit_format.html

Citation:

Gsponer T, Weigel R, Davies MA, Bolton C, Moultrie H, Vaz P, Rabie H, Technau K, Ndirangu J, Eley B, Garone D, Wellington M, Giddy J, Ehmer J, Egger M, Keiser O; IeDEA Southern Africa. Variability of growth in children starting antiretroviral treatment in southern Africa. Pediatrics. 2012 Oct;130(4):e966-77. doi: 10.1542/peds.2011-3020. Epub 2012 Sep 17. PubMed PMID: 22987878; PubMed Central PMCID: PMC3457616.