Growth in HIV-infected children on long-term antiretroviral therapy

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dc.contributor.author Feucht, Ute Dagmar
dc.contributor.author Van Bruwaene, L.
dc.contributor.author Becker, Piet J.
dc.contributor.author Kruger, Mariana
dc.date.accessioned 2016-06-20T05:44:48Z
dc.date.issued 2016-05
dc.description.abstract OBEJECTIVES : To describe growth in HIV‐infected children on long‐term antiretroviral therapy (ART) and to assess social, clinical, immunological and virological factors associated with suboptimal growth. METHODS : This observational cohort study included all HIV‐infected children at an urban ART site in South Africa who were younger than 5 years at ART initiation and with more than 5 years of follow‐up. Growth was assessed using weight‐for‐age Z‐scores (WAZ), height‐for‐age Z‐scores (HAZ) and body mass index (BMI)‐forage Z‐scores (BAZ). Children were stratified according to pre‐treatment anthropometry and age. Univariate and mixed linear analysis was used to determine associations between independent variables and weight and height outcomes. RESULTS : Majority of the 159 children presented with advanced clinical disease (90%) and immunosuppression (89%). Pre‐treatment underweight, stunting and wasting occurred commonly (WAZ<‐2= 50%, HAZ<‐2= 73%, BAZ<‐2= 19%). Weight and BMI improvement occurred during the initial 12 months, while height improved during the entire 5‐year period. Height at study exit was significantly worse for children with growth impairment at ART initiation (p<0.001), whilst infants (<1 year) demonstrated superior improvement in terms of BMI (p=0.04). Tuberculosis was an independent risk factor for suboptimal weight (p=0.01) and height (p=0.02) improvement. Weight gain was additionally hindered by lack of electricity (p=0.04). Immune reconstitution and virological suppression were not associated with being underweight or stunted at study end point. CONCLUSIONS : Malnutrition was a major clinical concern for this cohort of HIV‐infected children. Early ART initiation, tuberculosis co‐infection management and nutritional interventions are crucial to ensure optimal growth in HIV‐infected children. en_ZA
dc.description.department Paediatrics and Child Health en_ZA
dc.description.embargo 2017-05-31
dc.description.librarian hb2016 en_ZA
dc.description.uri http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-3156 en_ZA
dc.identifier.citation Feucht, UD, Van Bruwaene, L, Becker, PJ & Kruger, M 2016, 'Growth in HIV-infected children on long-term antiretroviral therapy', Tropical Medicine and International Health, vol. 21, no. 5, pp. 619-629. en_ZA
dc.identifier.issn 1360-2276 (print)
dc.identifier.issn 1365-3156 (online)
dc.identifier.other 10.1111/tmi.12685
dc.identifier.uri http://hdl.handle.net/2263/53242
dc.language.iso en en_ZA
dc.publisher Wiley en_ZA
dc.rights © 2016 John Wiley and Sons, Ltd. This is the pre-peer reviewed version of the following article : Growth in HIV-infected children on long-term antiretroviral therapy, Tropical Medicine and International Health, vol. 21, no. 5, pp. 619-629, 2016. doi : 10.1111/tmi.12685 . The definite version is available at : http://onlinelibrary.wiley.comjournal/10.1111/(ISSN)1365-3156. en_ZA
dc.subject Children en_ZA
dc.subject Growth en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject Tuberculosis (TB) en_ZA
dc.subject Antiretroviral therapy (ART) en_ZA
dc.title Growth in HIV-infected children on long-term antiretroviral therapy en_ZA
dc.type Postprint Article en_ZA


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