Growth and pubertal development in HIV-infected adolescents

Williams, Paige L.; Jesson, Julie

doi:10.1097/coh.0000000000000450

Cited by 35 publications

(28 citation statements)

References 39 publications

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“…In this study we show that the time to reach 50% of each phase fractional height increased with the age at ART initiation. This is consistent with previous studies [8, 41–47], indicating that ART initiation at an early age significantly increased the height-growth velocity. Also, the maximal height ( HT max ) was related to the child’s sex –as in the general population.…”

Section: Discussionsupporting

confidence: 93%

“…Interestingly, height-growth velocity did not differ according to the initial ART regimen, even if it was a dual NRTI regimen as compared to a triple combination. Other studies did not find any difference of HAZ [8, 11] and weight-growth velocity [41, 48] according to the type of ART regimen. Also, the immunological or virological status at baseline had no impact on the height-growth velocity.…”

Section: Discussionmentioning

confidence: 95%

“…HIV infection in children has been associated with growth delays in terms of weight (wasting and underweight) and height (stunting) [1–9]. Antiretroviral treatments (ART) have been shown to have a positive impact on the evolution of the anthropometric parameters [8–13], but studies have mostly focused on the improvement of the weight-for-age z-score (WAZ) [9, 14–18]. Results of the several studies analyzing the effect of ART on height-for-age z-score (HAZ), a better indicator of the general development of children in the long term [19–23] are conflicting, some suggesting a favourable effect [24–27] and others not [28–32].…”

Section: Introductionmentioning

confidence: 99%

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Impact of antiretroviral treatment on height evolution of HIV infected children

et al. 2019

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Background Antiretroviral treatment (ART) has been shown to have a beneficial effect on the weight evolution but its effect on height remains unclear. We described patterns of height evolution and identified predictors of catch-up growth in HIV-infected children on ART. Methods To describe the height evolution from birth to adulthood, we developed a nonlinear mixed effect model using data from perinatally HIV-infected children who initiated ART from 1999 to 2013 in a prospective cohort study in Thailand. The main covariates of interest were: sex, ART regimen (dual nucleoside reverse-transcriptase inhibitor, non-nucleoside reverse transcriptase inhibitor (NNRTI)-, or protease inhibitor (PI)-based), baseline CD4 percentage, HIV-RNA load and CDC HIV Classification stage and occurrence of AIDS-defining events. Results A total 477 children (43% boys) contributed 18,596 height measurements over a median duration of 6.3 years on ART (interquartile range, 3.0 to 8.3). At ART initiation, median age was 6.2 years (1.8 to 9.6), 16% of children were underweight (weight-for-age z-score < − 2), 49% presented stunting (height-for-age z-score < − 2), and 7% wasting (weight-for-height z-score < − 2). The most frequent regimen at ART initiation was NNRTI-based (79%). A model with 4 components, birth length and 3 exponential functions of age accounting for the 3 growth phases was developed and show that the height-growth velocity was inversely associated with the age at ART initiation, the adult height was significantly lower in those who had experienced at least one AIDS-defining event while, as expected, the model found that adult height in females was lower than in males. Age at ART initiation, type of ART regimen, CDC stage, CD4 percentages, and HIV-RNA load were not associated with the final height. Conclusions The younger the children at ART initiation, the greater the effect on height-growth velocity, supporting the World Health Organization’s recommendation to start ART as early as possible. However, final adult height was not linked to the age at ART initiation. Electronic supplementary material The online version of this article (10.1186/s12887-019-1663-8) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Impact of antiretroviral treatment on height evolution of HIV infected children

et al. 2019

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“…Stunting developed in the first years of life is known to be difficult, even impossible to resolve if it is not treated in time [33]. Children initiating ART too late are at a high risk for stunting at ART initiation and will likely remain small for their age throughout adolescence [34]. Another explanation for this phenomenon could be that these children are living in poorer socio-economic conditions, where food insecurity is high.…”

Section: Discussionmentioning

confidence: 99%

Growth in the first 5 years after antiretroviral therapy initiation among HIV‐infected children in the IeDEA West African Pediatric Cohort

Jesson

Ephoevi-Ga

Desmonde

et al. 2019

Tropical Med Int Health

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objective To describe growth evolution and its correlates in the first 5 years of antiretroviral therapy (ART) initiation among HIV-infected children followed up in West Africa.methods All HIV-infected children younger than 10 years followed in the IeDEA pWADA cohort while initiating ART, with at least one anthropometric measurement within the first 5 years of treatment were included in the study. Growth was described according to the WHO child growth standards, using Weight-for-age Z-score (WAZ), Height-for-age Z-score (HAZ) and Weight-for-Height/BMI-for-age Z-score (WHZ/BAZ). Growth evolution and its correlates, measured at ART initiation, were modelled in individual linear mixed models for each anthropometric indicator, with a spline term added at the 12-, 24-and 9-month time point for WAZ, HAZ and WHZ/BAZ, respectively.results Among the 4156 children selected (45% girls, median age at ART initiation 3.9 years [IQR interquartile range 1.9-6.6], and overall 68% malnourished at ART initiation), important gains were observed in the first 12, 24 and 9 months on ART for WAZ, HAZ and WHZ/BAZ, respectively. Correlates at ART initiation of a better growth evolution overtime were early age (<2 years of age), severe immunodeficiency for age, and severity of malnutrition.conclusions Growth evolution is particularly strong within the first 2 years on ART but slows down after this period. Weight and height gains help to recover from pre-ART growth deficiency but are insufficient for the most severely malnourished. The first year on ART could be the best period for nutritional interventions to optimize growth among HIV-infected children in the long-term.

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“…Growth deficiency is a key concern for children and adolescents living with HIV . There are overlapping effects on growth resulting from a vicious cycle between malnutrition and HIV infection.…”

Section: Introductionmentioning

confidence: 99%

Stunting and growth velocity of adolescents with perinatally acquired HIV: differential evolution for males and females. A multiregional analysis from the IeDEA global paediatric collaboration

et al. 2019

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Introduction Stunting is a key issue for adolescents with perinatally acquired HIV (APH) that needs to be better understood. As part of the IeDEA multiregional consortium, we described growth evolution during adolescence for APH on antiretroviral therapy (ART). Methods We included data from sub‐Saharan Africa, the Asia‐Pacific, and the Caribbean, Central and South America regions collected between 2003 and 2016. Adolescents on ART, reporting perinatally acquired infection or entering HIV care before 10 years of age, with at least one height measurement between 10 and 16 years of age, and followed in care until at least 14 years of age were included. Characteristics at ART initiation and at 10 years of age were compared by sex. Correlates of growth defined by height‐for‐age z‐scores (HAZ) between ages 10 and 19 years were studied separately for males and females, using linear mixed models. Results Overall, 8737 APH were included, with 46% from Southern Africa. Median age at ART initiation was 8.1 years (interquartile range (IQR) 6.1 to 9.6), 50% were females, and 41% were stunted (HAZ<−2 SD) at ART initiation. Males and females did not differ by age and stunting at ART initiation, CD4 count over time or retention in care. At 10 years of age, 34% of males were stunted versus 39% of females (p < 0.001). Females had better subsequent growth, resulting in a higher prevalence of stunting for males compared to females by age 15 (48% vs. 25%) and 18 years (31% vs. 15%). In linear mixed models, older age at ART initiation and low CD4 count were associated with poor growth over time (p < 0.001). Those stunted at 10 years of age or at ART initiation had the greatest growth improvement during adolescence. Conclusions Prevalence of stunting is high among APH worldwide. Substantial sex‐based differences in growth evolution during adolescence were observed in this global cohort, which were not explained by differences in age of access to HIV care, degree of immunosuppression or region. Other factors influencing growth differences in APH, such as differences in pubertal development, should be better documented, to guide further research and inform interventions to optimize growth and health outcomes among APH.

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Growth and pubertal development in HIV-infected adolescents

Cited by 35 publications

References 39 publications

Impact of antiretroviral treatment on height evolution of HIV infected children

Impact of antiretroviral treatment on height evolution of HIV infected children

Growth in the first 5 years after antiretroviral therapy initiation among HIV‐infected children in the IeDEA West African Pediatric Cohort

Stunting and growth velocity of adolescents with perinatally acquired HIV: differential evolution for males and females. A multiregional analysis from the IeDEA global paediatric collaboration

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