TY - JOUR
T1 - Weight and height z-scores improve after initiating ART among HIV-infected children in rural Zambia
T2 - A cohort study
AU - Sutcliffe, Catherine G.
AU - van Dijk, Janneke H.
AU - Munsanje, Bornface
AU - Hamangaba, Francis
AU - Sinywimaanzi, Pamela
AU - Thuma, Philip E
AU - Moss, William J.
N1 - Funding Information:
We thank the children and their parents for participating in the study. We thank the staff at the HIV clinic, the study team (Jeridy Munsanje, Matthias Muleko, and Justin Moono), and the clinical research laboratory staff (Pisgah Sikwangala, Jay Sikalima, and Lushomo Chikobolo) for their assistance with the study. This work was made possible by support from the President’s Emergency Plan for AIDS Relief (PEPFAR) through Cooperative Agreement U62/ CCU322428 from the Department of Health and Human Services (DHHS)/ Centers for Disease Control and Prevention (CDC), Global AIDS Program. The findings and conclusions included in its content are solely the responsibility of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry. Funders of this study had no part in the design, data collection, analysis, or interpretation of the findings of this study, and did not take part in the writing or the decision to publish this manuscript.
PY - 2011/3/1
Y1 - 2011/3/1
N2 - Background: Deficits in growth observed in HIV-infected children in resource-poor settings can be reversed with antiretroviral treatment (ART). However, many of the studies have been conducted in urban areas with older pediatric populations. This study was undertaken to evaluate growth patterns after ART initiation in a young pediatric population in rural Zambia with a high prevalence of undernutrition.Methods: Between 2007 and 2009, 193 HIV-infected children were enrolled in a cohort study in Macha, Zambia. Children were evaluated every 3 months, at which time a questionnaire was administered, height and weight were measured, and blood specimens were collected. Weight- and height-for-age z-scores were constructed from WHO growth standards. All children receiving ART at enrollment or initiating ART during the study were included in this analysis. Linear mixed effects models were used to model trajectories of weight and height-for-age z-scores.Results: A high proportion of study children were underweight (59%) and stunted (72%) at treatment initiation. Improvements in both weight- and height-for-age z-scores were observed, with weight-for-age z-scores increasing during the first 6 months of treatment and then stabilizing, and height-for-age z-scores increasing consistently over time. Trajectories of weight-for-age z-scores differed by underweight status at treatment initiation, with children who were underweight experiencing greater increases in z-scores in the first 6 months of treatment. Trajectories of height-for-age z-scores differed by age, with children older than 5 years of age experiencing smaller increases over time.Conclusions: Some of the effects of HIV on growth were reversed with ART initiation, although a high proportion of children remained underweight and stunted after two years of treatment. Partnerships between treatment and nutrition programs should be explored so that HIV-infected children can receive optimal nutritional support.
AB - Background: Deficits in growth observed in HIV-infected children in resource-poor settings can be reversed with antiretroviral treatment (ART). However, many of the studies have been conducted in urban areas with older pediatric populations. This study was undertaken to evaluate growth patterns after ART initiation in a young pediatric population in rural Zambia with a high prevalence of undernutrition.Methods: Between 2007 and 2009, 193 HIV-infected children were enrolled in a cohort study in Macha, Zambia. Children were evaluated every 3 months, at which time a questionnaire was administered, height and weight were measured, and blood specimens were collected. Weight- and height-for-age z-scores were constructed from WHO growth standards. All children receiving ART at enrollment or initiating ART during the study were included in this analysis. Linear mixed effects models were used to model trajectories of weight and height-for-age z-scores.Results: A high proportion of study children were underweight (59%) and stunted (72%) at treatment initiation. Improvements in both weight- and height-for-age z-scores were observed, with weight-for-age z-scores increasing during the first 6 months of treatment and then stabilizing, and height-for-age z-scores increasing consistently over time. Trajectories of weight-for-age z-scores differed by underweight status at treatment initiation, with children who were underweight experiencing greater increases in z-scores in the first 6 months of treatment. Trajectories of height-for-age z-scores differed by age, with children older than 5 years of age experiencing smaller increases over time.Conclusions: Some of the effects of HIV on growth were reversed with ART initiation, although a high proportion of children remained underweight and stunted after two years of treatment. Partnerships between treatment and nutrition programs should be explored so that HIV-infected children can receive optimal nutritional support.
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U2 - 10.1186/1471-2334-11-54
DO - 10.1186/1471-2334-11-54
M3 - Article
C2 - 21362177
AN - SCOPUS:79952084051
SN - 1471-2334
VL - 11
JO - BMC infectious diseases
JF - BMC infectious diseases
M1 - 54
ER -