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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Antiretroviral therapy for HIV-1 infected adolescents in Uganda: Assessing the impact on growth and sexual maturation
Journal of Pediatric Infectious Diseases, Volume 3, No. 2, Year 2008
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Description
There is a paucity of knowledge about perinatally infected human immunodeficiency virus (HIV) positive children surviving into their adolescent years, especially from sub-Saharan Africa. Although studies have described the effects of the disease on the physical and sexual maturation of this population, their response to highly active antiretroviral therapy has not been systematically studied. At the pediatric infectious diseases clinic in Mulago hospital, Kampala, Uganda, we evaluated the effect of antiretroviral therapy (ART) on 118 treatment-naive, perinatally-infected HIV positive adolescents between the ages of 10-19 for 12 months. We monitored physical growth using The Centers for Disease Control and Prevention and recently published World Health Organization (WHO) reference growth standards for height and weight measurements as well as sexual maturation using Tanner staging. Laboratory tests including: complete blood count, absolute CD4 cell count and percentage, and HIV-1 RNA viral load, were performed at baseline and at 3-month intervals. Of 118 children, 64% were female; the median age was 13.6 years old. At baseline, 75% were classified as WHO clinical stages III and IV, with a median CD4 count of 124 cells/ul. Apart from four adolescents, all were on first-line antiretroviral therapy with 2 nucleoside reverse transcriptase inhibitors and 1 non-nucleoside reverse transcriptase inhibitors. After 6 months, the median CD4 count was 304 cells/μL, increasing to 370 cells/μL, by 12 months. Antiretroviral therapy was virologically suppressive (HIV-1 RNA viral load <400 copies/mL) in 79% of the adolescents at 6 months and in 89% at 12 months. Six (5%) patients died during the 12-month study. The median baseline height for age Z score was -2.41 which improved to a median of -1.96 by 12 months (P < 0.0001). The median baseline weight for age Z score was -2.61 and improved to -1.26 by 12 months (P < 0.0001). The median body mass index Z score increased from -1.39 to -0.47 by 12 months (P < 0.0001). At baseline, 63% of the adolescents were noted to have delayed pubertal maturation; this only reduced slightly to 60% after 12 months. Adolescents with predominantly perinatally-acquired HIV infection and significant disease burden showed appropriate virologic and immunological response to ART in addition to having clinically significant improvements in growth and some improvement in sexual maturation. © 2008 IOS Press. All rights reserved.
Authors & Co-Authors
Bakeera-Kitaka, Sabrina
Uganda, Kampala
Makerere University
Uganda, Kampala
School of Medicine, Makerere University College of Health Sciences
McKellar, Mehri S.
United States, Salt Lake City
The University of Utah
Snider, Cynthia
United States, Salt Lake City
The University of Utah
Kekitiinwa, Adeodata R.
Uganda, Kampala
Makerere University
Piloya, Theresa Were
Uganda, Kampala
Makerere University
Musoke, Philippa Martha
Uganda, Kampala
Makerere University
Ronald, Allan R.
Uganda, Kampala
Academic Alliance for Aids Care and Prevention in Africa
Javanbakht, Marjan
United States, Los Angeles
University of California, Los Angeles
Colebunders, Robert Leon
Uganda, Kampala
Academic Alliance for Aids Care and Prevention in Africa
Belgium, Antwerpen
Universiteit Antwerpen
Statistics
Citations: 9
Authors: 9
Affiliations: 6
Identifiers
ISSN:
13057707
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Study Locations
Uganda
Participants Gender
Female