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Growth in the first 5 years after antiretroviral therapy initiation among HIV‐infected children in the IeDEA West African Pediatric Cohort
Author(s) -
Jesson Julie,
EphoeviGa Ayoko,
Desmonde Sophie,
AkeAssi MarieHélène,
D'Almeida Marcelline,
Sy Haby Signaté,
Malateste Karen,
AmorissaniFolquet Madeleine,
Dicko Fatoumata,
Kouadio Kouakou,
Renner Lorna,
Leroy Valériane
Publication year - 2019
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13237
Subject(s) - medicine , antiretroviral therapy , cohort , pediatrics , human immunodeficiency virus (hiv) , sida , cohort study , viral disease , virology , viral load
Summary 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.