Authors: Buonora, Sibelle¹; Nogueira, Susie²; Pone, Marcus Vinicius³; Aloé, Marisa⁴; Oliveira, Ricardo Hugo¹; Hofer, Cristina²

Source: Annals of Tropical Paediatrics: International Child Health, Volume 28, Number 1, March 2008 , pp. 59-64(6)

Publisher: Maney Publishing

Abstract:

Background: Growth failure in HIV-infected children is an important factor in either initiating or changing antiretroviral therapy (ART). This study assesses the impact of HIV infection on growth parameters of adolescents who acquired HIV vertically.

Methods: This retrospective, longitudinal study involved adolescents aged 10–20 years with vertically-acquired HIV infection who were followed up in one of the three main referral centres for paediatric HIV/AIDS in Rio de Janeiro, Brazil. Length, weight and variables related to demographic, clinical and laboratory issues were analysed.

Results: 108 subjects were enrolled. Median age was 12.7 years, median duration of follow-up was 97.2 months and 61 (56.5%) were female. The difference between the baseline and final weight Z-scores was −0.31 (p=0.02). Patients with final weight Z-scores ≤ −2 used more ART regimens (average 4.13) than those with Z-scores > −2 (average 2.90, p<0.01) and also had a lower final CD4+ cell percentage — average 19% vs 24% (p<0.01), respectively. The difference between baseline and final-height Z-scores was −0.27 (p<0.01). Several factors were associated with a final-height Z-score ≤ −2: clinical stage C during follow-up (RR 1.60, 95% CI 1.11–2.31), chronic diarrhoea during follow-up (RR 2.02, 95% CI 1.04–3.90), HAART use (RR 1.41, 95% CI 1.16–1.71), number of ART regimens (p<0.01) and final CD4+ cell percentage (p<0.01). In multivariate analysis, presentation in clinical stage C during follow-up was the only significant variable (OR 4.04, 95% CI 1.23–13.28).

Conclusion: Even on HAART, HIV-infected adolescents have lower growth parameters than the normal population and this is associated with a worse prognosis.

Document Type: Research Article

DOI: http://dx.doi.org/10.1179/146532808X270699

Affiliations: 1: Department of Pediatrics, Federal University of Rio de Janeiro, Brazil 2: Infectious Diseases Service, Department of Preventive Medicine, Federal University of Rio de Janeiro, Brazil 3: Department of Pediatrics, Fernandes Figueira Institute, Rio de Janeiro, Brazil 4: Department of Pediatrics, Jesus Municipal Hospital, Rio de Janeiro, Brazil

Publication date: 2008-03-01

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• In 2012 Annals of Tropical Paediatrics changed its name to Paediatrics and International Child Health to reflect changes and developments in the subject area. View the issues of Paediatrics and International Child Health available online.
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