Growth Patterns of HIV Infected Indian Children in Response to ART: A Clinic Based Cohort Study

Parchure, Ritu; Kulkarni, Vinay; Darak, Trupti; Mhaskar, Rahul; Miladinović, Branko; Emmanuel, Patricia

doi:10.1007/s12098-014-1659-1

Cited by 10 publications

(11 citation statements)

References 22 publications

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“…No statistical differences were observed in initial body weight, assessed from PD 8 to PD 10, results which are consistent with those previously reported in male Sprague-Dawley rats stereotaxically injected with Tat and/or gp120, HIV-1 viral proteins, on PD 1 (Fitting et al 2008) and in HIV-1 infected children (Guillen et al 2007; Parachure et al 2015). HIV-1 Tg animals exhibited later eye opening, indicating an early selective alteration in somatic growth.…”

Section: Discussionsupporting

confidence: 91%

Selective developmental alterations in The HIV-1 transgenic rat: Opportunities for diagnosis of pediatric HIV-1

2016

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Since the advent of combination antiretroviral therapy (cART), pediatric HIV-1 (PHIV) has evolved from a fatal disease to a chronic disease as children perinatally infected with HIV-1 survive into adulthood. The HIV-1 transgenic (Tg) rat, which expresses 7 of the 9 HIV-1 genes constitutively throughout development, was used to model the early development of chronic neurological impairment in PHIV. Male and female Fischer HIV-1 Tg and F344N control rats, sampled from 35 litters, were repeatedly assessed during early development using multiple experimental paradigms, including somatic growth, locomotor activity, cross-modal prepulse inhibition (PPI) and gap-prepulse inhibition (gap-PPI). Later eye opening was observed in HIV-1 Tg animals relative to controls. HIV-1 Tg animals exhibited a shift in the development of locomotor activity implicating alterations in the maturation of the forebrain cholinergic inhibitory system. Alterations in the development of PPI and perceptual sharpening were observed in both auditory and visual PPI as indexed by a relative insensitivity to the dimension of time (ms for ISI; days of age for perceptual sharpening) as a function of the HIV-1 transgene. Presence of the HIV-1 transgene was diagnosed with 97.1% accuracy using auditory and visual PPI measurements from PD 17 and 21. Early selective developmental alterations observed in the HIV-1 Tg rats provide an opportunity for the development of a point-of-care screening tool, which would permit for early diagnosis of PHIV and improve the long-term outcome for children perinatally infected with HIV-1.

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Section: Discussionsupporting

confidence: 91%

Selective developmental alterations in The HIV-1 transgenic rat: Opportunities for diagnosis of pediatric HIV-1

2016

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“…This resulted in the BMI rapidly increasing to above the zero Z-score during the first year of treatment, with this effect more pronounced in infants. This ART-related growth improvement is comparable to descriptions from other ART follow-up studies from India and Southern Africa [15,22,24,26]. At the end of the 5-year follow-up period, stunting was the most important growth deficit observed in 20.2% of children, which is higher than South African malnutrition data in the age group 5-10 years in the year 2005 (13.9%) [32].…”

Section: Discussionsupporting

confidence: 82%

“…Age at ART initiation impacted on growth improvement: Children older than 3 years experienced a lower weight and height increase than younger children, and this resulted in better BMI outcome in infants, while height outcomes did not differ across age groups. Previous studies consistently describe improved weight outcomes for younger children [16,18,21,22,24,26,[35][36][37][38], possibly related to less severe gastrointestinal impairment and shorter duration of chronic immune activation [39,40]. Reports on the impact of age on height differ between studies, with improved height outcomes with younger age in some studies [23,24,26,35], while others reported no difference [36] or worse height outcomes for younger children [20,22].…”

Section: Discussionmentioning

confidence: 97%

“…Previous studies consistently describe improved weight outcomes for younger children , possibly related to less severe gastrointestinal impairment and shorter duration of chronic immune activation . Reports on the impact of age on height differ between studies, with improved height outcomes with younger age in some studies , while others reported no difference or worse height outcomes for younger children . HIV‐infected children are increasingly reaching adulthood due to the availability of ART; therefore, studies to evaluate the impact of age at ART initiation on the timing and magnitude of the pubertal growth spurt and final adult height are needed.…”

Section: Discussionmentioning

confidence: 99%

“…ART has a positive effect on weight and, to a lesser extent, on height growth . As opposed to studies from developed countries [10,11,27], reports from developing countries have not shown normalisation of growth parameters [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. These studies, however, generally had relatively short follow-up periods of up to 2 years and were hampered by substantial loss to follow-up.…”

Section: Introductionmentioning

confidence: 99%

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

Feucht

Bruwaene

Becker

et al. 2016

Tropical Med Int Health

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Abstractobjectives 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 Zscores (HAZ) and body mass index (BMI)-for-age Z-scores (BAZ). Children were stratified according to pre-treatment anthropometry and age. Univariate and mixed linear analysis were used to determine associations between independent variables and weight and height outcomes.results The majority of the 159 children presented with advanced clinical disease (90%) and immunosuppression (89%). Before treatment underweight, stunting and wasting were common (WAZ<À2 = 50%, HAZ<À2 = 73%, BAZ<À2 = 19%). Weight and BMI improved during the initial 12 months, while height improved over the entire 5-year period. Height at study exit was significantly worse for children with growth impairment at ART initiation (P < 0.001), and 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 also hindered by lack of electricity (P = 0.04). Immune reconstitution and virological suppression were not associated with being underweight or stunted at study endpoint.

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Dose‐dependent neurocognitive deficits following postnatal day 10 HIV‐1 viral protein exposure: Relationship to hippocampal anatomy parameters

Fitting

McLaurin

Booze

et al. 2017

Intl J of Devlp Neuroscience

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Despite the availability of antiretroviral prophylactic treatment, pediatric human immunodeficiency virus type 1 (HIV-1) continues to be a significant risk factor in the post-cART era. The time of infection (i.e., during pregnancy, delivery or breastfeeding) may play a role in the development of neurocognitive deficits in pediatric HIV-1. HIV-1 viral protein exposure on postnatal day (P)1, preceding the postnatal brain growth spurt in rats, had deleterious effects on neurocognitive development and anatomical parameters of the hippocampus (Fitting et al., 2008a,b). In the present study, rats were stereotaxically injected with HIV-1 viral proteins, including Tat and gp120, on P10 to further examine the role of timing on neurocognitive development and anatomical parameters of the hippocampus (Fitting et al., 2010). The dose-dependent virotoxin effects observed across development following P10 Tat exposure were specific to spatial learning and absent from prepulse inhibition and locomotor activity. A relationship between alterations in spatial learning and/or memory and hippocampal anatomical parameters was noted. Specifically, the estimated number of neurons and astrocytes in the hilus of the dentate gyrus explained 70% of the variance of search behavior in Morris water maze acquisition training for adolescents and 65% of the variance for adults; a brain-behavior relationship consistent with observations following P1 viral protein exposure. Collectively, late viral protein exposure (P10) results in selective alterations in neurocognitive development without modifying measures of somatic growth, preattentive processing, or locomotor activity, as characterized by early viral protein exposure (P1). Thus, timing may be a critical factor in disease progression, with children infected with HIV earlier in life being more vulnerable to CNS disease.

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Growth Patterns of HIV Infected Indian Children in Response to ART: A Clinic Based Cohort Study

Abstract: The prevalence of stunting and underweight was high at ART initiation. Sustained catch-up growth was seen with ART. The study highlights the benefit of early ART in achieving normal growth in CLHIV.

Cited by 10 publications

References 22 publications

Selective developmental alterations in The HIV-1 transgenic rat: Opportunities for diagnosis of pediatric HIV-1

Selective developmental alterations in The HIV-1 transgenic rat: Opportunities for diagnosis of pediatric HIV-1

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

Dose‐dependent neurocognitive deficits following postnatal day 10 HIV‐1 viral protein exposure: Relationship to hippocampal anatomy parameters

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