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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Younger age at HAART initiation is associated with more rapid growth reconstitution
AIDS, Volume 25, No. 3, Year 2011
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Description
Objectives: Patterns of growth following highly active antiretroviral therapy (HAART) administration among children are not well defined. The objective of this study was to determine rates and predictors of growth reconstitution among children on HAART. Methods: A study was conducted among HIV-1-infected children initiating HAART at an HIV treatment clinic in Kenya. Kaplan-Meier survival curves and Cox proportional hazards regression models compared catch-up growth (Z-score ≥0) at 12 months post-HAART. Multivariate linear mixed-effects models determined rates and predictors of growth following HAART. Results: One hundred and seventy-three HIV-1-infected children initiated HAART with a median age of 4.7 years [interquartile range (IQR) 2.4, 7.0]. At baseline, children below 3 years had lower weight-for-age (WAZ) and weight-for-height (WHZ) Z-scores than children 3-5 and 6-10 years (WAZ: P = 0.03; WHZ: P = 0.006). Adjusting for baseline growth, children below 3 years were two to three-fold more likely to attain population age-norms (Z-score = 0) than 6-10 years (WAZ: P = 0.055; WHZ: P = 0.005) at 12 months post-HAART. After adjustment, children below 3 years had higher increases in WAZ and WHZ following HAART than 6-10 years (WAZ: P = 0.006; WHZ: P = 0.005). Children at WHO stage at least 3 at baseline experienced more rapid WHZ reconstitution (P = 0.002). Food supplementation while on HAART was associated with increased monthly gains in weight indices (WAZ: P = 0.001; WHZ: P = 0.005), and multivitamins were associated with greater increases in height (P < 0.01). Conclusion: Following HAART initiation, younger children had more rapid catch-up to the population-average weight of their peers than older children, demonstrating growth benefit of earlier HAART. In addition to HAART, food supplementation and multivitamins may also accelerate growth reconstitution. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
McGrath, Christine J.
United States, Seattle
University of Washington
Chung, Michael Hoonbae
United States, Seattle
University of Washington
Richardson, Barbra Ann
United States, Seattle
University of Washington
United States, Seattle
Fred Hutchinson Cancer Research Center
Benki-Nugent, Sarah F.
United States, Seattle
University of Washington
Warui, Danson
Kenya, Nairobi
Coptic Hospital
John-Stewart, Grace C.
United States, Seattle
University of Washington
Statistics
Citations: 56
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.1097/QAD.0b013e32834171db
e-ISSN:
14735571
Research Areas
Food Security
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Locations
Kenya