Growth in Virologically Suppressed HIV-Positive Children on Antiretroviral Therapy: Individual and Population-level References
BACKGROUND:Combination antiretroviral therapy (ART) suppresses viral replication in HIV-infected children. The growth of virologically suppressed children on ART has not been well documented. We aimed to develop dynamic reference curves for weight-for-age Z scores (WAZ) and height-for-age Z scores (...
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| Veröffentlicht in: | The Pediatric infectious disease journal 2015-10, Vol.34 (10), p.e254-e259 |
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| creator | Keiser, Olivia Blaser, Nello Davies, Mary-Ann Wessa, Patrick Eley, Brian Moultrie, Harry Rabie, Helena Technau, Karl-Günther Ndirangu, James Garone, Daniela Giddy, Janet Grimwood, Ashraf Gsponer, Thomas Egger, Matthias |
| description | BACKGROUND:Combination antiretroviral therapy (ART) suppresses viral replication in HIV-infected children. The growth of virologically suppressed children on ART has not been well documented. We aimed to develop dynamic reference curves for weight-for-age Z scores (WAZ) and height-for-age Z scores (HAZ).
METHODS:Children aged |
| doi_str_mv | 10.1097/INF.0000000000000801 |
| format | Article |
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METHODS:Children aged <11 years at ART initiation with continuously undetectable viral loads (<400 copies/mL) treated at 7 South African ART programs with routine viral load monitoring were included. We used multilevel models to define trajectories of WAZ and HAZ up to 3 years and developed a web application to monitor trajectories in individual children.
RESULTS:A total of 4876 children were followed for 7407 person-years. Analyses were stratified by baseline Z scores and age, which were the most important predictors of growth response. The youngest children showed the most pronounced increase in weight and height initially but catch-up growth stagnated after 1–2 years. Three years after starting ART, WAZ ranged from −2.2 [95% prediction interval (PrI), −5.6 to 0.8] in children with baseline age >5 years and Z score less than −3 to 0.0 (95% PrI, −2.7 to 2.4) in children with baseline age <2 years and WAZ greater than −1. For HAZ, the corresponding range was −2.3 (95% PrI, −4.9 to 0.3) in children with baseline age >5 years and Z score less than −3 to 0.3 (95% PrI, −3.1 to 3.4) in children with baseline age 2–5 years and HAZ greater than −1.
CONCLUSIONS:We have developed an online tool to calculate reference trajectories in fully suppressed children. The web application could help to define “optimal” growth response and identify children with treatment failure.</description><identifier>ISSN: 0891-3668</identifier><identifier>EISSN: 1532-0987</identifier><identifier>DOI: 10.1097/INF.0000000000000801</identifier><identifier>PMID: 26192393</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Anti-HIV Agents - pharmacology ; Anti-HIV Agents - therapeutic use ; Child ; Child, Preschool ; Female ; Growth Charts ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - physiopathology ; HIV Infections - virology ; HIV-1 - drug effects ; Humans ; Infant ; Male ; Viral Load - drug effects ; Waist-Height Ratio</subject><ispartof>The Pediatric infectious disease journal, 2015-10, Vol.34 (10), p.e254-e259</ispartof><rights>Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3601-33f1c8c4efe6c05fdd57e3d7d01208b087576c271cbc6c3295e68e784896cd373</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26192393$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Keiser, Olivia</creatorcontrib><creatorcontrib>Blaser, Nello</creatorcontrib><creatorcontrib>Davies, Mary-Ann</creatorcontrib><creatorcontrib>Wessa, Patrick</creatorcontrib><creatorcontrib>Eley, Brian</creatorcontrib><creatorcontrib>Moultrie, Harry</creatorcontrib><creatorcontrib>Rabie, Helena</creatorcontrib><creatorcontrib>Technau, Karl-Günther</creatorcontrib><creatorcontrib>Ndirangu, James</creatorcontrib><creatorcontrib>Garone, Daniela</creatorcontrib><creatorcontrib>Giddy, Janet</creatorcontrib><creatorcontrib>Grimwood, Ashraf</creatorcontrib><creatorcontrib>Gsponer, Thomas</creatorcontrib><creatorcontrib>Egger, Matthias</creatorcontrib><creatorcontrib>for IeDEA Southern Africa</creatorcontrib><title>Growth in Virologically Suppressed HIV-Positive Children on Antiretroviral Therapy: Individual and Population-level References</title><title>The Pediatric infectious disease journal</title><addtitle>Pediatr Infect Dis J</addtitle><description>BACKGROUND:Combination antiretroviral therapy (ART) suppresses viral replication in HIV-infected children. The growth of virologically suppressed children on ART has not been well documented. We aimed to develop dynamic reference curves for weight-for-age Z scores (WAZ) and height-for-age Z scores (HAZ).
METHODS:Children aged <11 years at ART initiation with continuously undetectable viral loads (<400 copies/mL) treated at 7 South African ART programs with routine viral load monitoring were included. We used multilevel models to define trajectories of WAZ and HAZ up to 3 years and developed a web application to monitor trajectories in individual children.
RESULTS:A total of 4876 children were followed for 7407 person-years. Analyses were stratified by baseline Z scores and age, which were the most important predictors of growth response. The youngest children showed the most pronounced increase in weight and height initially but catch-up growth stagnated after 1–2 years. Three years after starting ART, WAZ ranged from −2.2 [95% prediction interval (PrI), −5.6 to 0.8] in children with baseline age >5 years and Z score less than −3 to 0.0 (95% PrI, −2.7 to 2.4) in children with baseline age <2 years and WAZ greater than −1. For HAZ, the corresponding range was −2.3 (95% PrI, −4.9 to 0.3) in children with baseline age >5 years and Z score less than −3 to 0.3 (95% PrI, −3.1 to 3.4) in children with baseline age 2–5 years and HAZ greater than −1.
CONCLUSIONS:We have developed an online tool to calculate reference trajectories in fully suppressed children. The web application could help to define “optimal” growth response and identify children with treatment failure.</description><subject>Anti-HIV Agents - pharmacology</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Growth Charts</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - physiopathology</subject><subject>HIV Infections - virology</subject><subject>HIV-1 - drug effects</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Viral Load - drug effects</subject><subject>Waist-Height Ratio</subject><issn>0891-3668</issn><issn>1532-0987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFvFCEYhonR2LX1HxjD0ctUGGYGxoNJs7HtJo022vZKWPimg7IwhZnZ7MXfLmZrU3soFxJ43oePvAi9o-SYkpZ_XH09PSaPlyD0BVrQmpUFaQV_iRZEtLRgTSMO0JuUfmaGVZS8RgdlQ9uStWyBfp_FsB17bD2-sTG4cGu1cm6Hf0zDECElMPh8dVNchmRHOwNe9taZCB4Hj0_8aCOMMcw2Koeveohq2H3CK2_sbM2Uz5Q3-DIMk1OjDb5wMIPD36GDrNCQjtCrTrkEb-_3Q3R9-uVqeV5cfDtbLU8uCs0akv_AOqqFrnKu0aTujKk5MMMNoSURayJ4zRtdcqrXutGsbGtoBHBRibbRhnF2iD7vvcO03oDR4Mc8sRyi3ai4k0FZ-f-Nt728DbOsak5EXWXBh3tBDHcTpFFubNLgnPIQpiQppyXnbc1oRqs9qmNIKUL38Awl8m91Mlcnn1aXY-8fj_gQ-tdVBsQe2AY3Qky_3LSFKHtQbuyfd_8BhdSomQ</recordid><startdate>201510</startdate><enddate>201510</enddate><creator>Keiser, Olivia</creator><creator>Blaser, Nello</creator><creator>Davies, Mary-Ann</creator><creator>Wessa, Patrick</creator><creator>Eley, Brian</creator><creator>Moultrie, Harry</creator><creator>Rabie, Helena</creator><creator>Technau, Karl-Günther</creator><creator>Ndirangu, James</creator><creator>Garone, Daniela</creator><creator>Giddy, Janet</creator><creator>Grimwood, Ashraf</creator><creator>Gsponer, Thomas</creator><creator>Egger, Matthias</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201510</creationdate><title>Growth in Virologically Suppressed HIV-Positive Children on Antiretroviral Therapy: Individual and Population-level References</title><author>Keiser, Olivia ; Blaser, Nello ; Davies, Mary-Ann ; Wessa, Patrick ; Eley, Brian ; Moultrie, Harry ; Rabie, Helena ; Technau, Karl-Günther ; Ndirangu, James ; Garone, Daniela ; Giddy, Janet ; Grimwood, Ashraf ; Gsponer, Thomas ; Egger, Matthias</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3601-33f1c8c4efe6c05fdd57e3d7d01208b087576c271cbc6c3295e68e784896cd373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Anti-HIV Agents - pharmacology</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Growth Charts</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - physiopathology</topic><topic>HIV Infections - virology</topic><topic>HIV-1 - drug effects</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Viral Load - drug effects</topic><topic>Waist-Height Ratio</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Keiser, Olivia</creatorcontrib><creatorcontrib>Blaser, Nello</creatorcontrib><creatorcontrib>Davies, Mary-Ann</creatorcontrib><creatorcontrib>Wessa, Patrick</creatorcontrib><creatorcontrib>Eley, Brian</creatorcontrib><creatorcontrib>Moultrie, Harry</creatorcontrib><creatorcontrib>Rabie, Helena</creatorcontrib><creatorcontrib>Technau, Karl-Günther</creatorcontrib><creatorcontrib>Ndirangu, James</creatorcontrib><creatorcontrib>Garone, Daniela</creatorcontrib><creatorcontrib>Giddy, Janet</creatorcontrib><creatorcontrib>Grimwood, Ashraf</creatorcontrib><creatorcontrib>Gsponer, Thomas</creatorcontrib><creatorcontrib>Egger, Matthias</creatorcontrib><creatorcontrib>for IeDEA Southern Africa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Pediatric infectious disease journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Keiser, Olivia</au><au>Blaser, Nello</au><au>Davies, Mary-Ann</au><au>Wessa, Patrick</au><au>Eley, Brian</au><au>Moultrie, Harry</au><au>Rabie, Helena</au><au>Technau, Karl-Günther</au><au>Ndirangu, James</au><au>Garone, Daniela</au><au>Giddy, Janet</au><au>Grimwood, Ashraf</au><au>Gsponer, Thomas</au><au>Egger, Matthias</au><aucorp>for IeDEA Southern Africa</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Growth in Virologically Suppressed HIV-Positive Children on Antiretroviral Therapy: Individual and Population-level References</atitle><jtitle>The Pediatric infectious disease journal</jtitle><addtitle>Pediatr Infect Dis J</addtitle><date>2015-10</date><risdate>2015</risdate><volume>34</volume><issue>10</issue><spage>e254</spage><epage>e259</epage><pages>e254-e259</pages><issn>0891-3668</issn><eissn>1532-0987</eissn><abstract>BACKGROUND:Combination antiretroviral therapy (ART) suppresses viral replication in HIV-infected children. The growth of virologically suppressed children on ART has not been well documented. We aimed to develop dynamic reference curves for weight-for-age Z scores (WAZ) and height-for-age Z scores (HAZ).
METHODS:Children aged <11 years at ART initiation with continuously undetectable viral loads (<400 copies/mL) treated at 7 South African ART programs with routine viral load monitoring were included. We used multilevel models to define trajectories of WAZ and HAZ up to 3 years and developed a web application to monitor trajectories in individual children.
RESULTS:A total of 4876 children were followed for 7407 person-years. Analyses were stratified by baseline Z scores and age, which were the most important predictors of growth response. The youngest children showed the most pronounced increase in weight and height initially but catch-up growth stagnated after 1–2 years. Three years after starting ART, WAZ ranged from −2.2 [95% prediction interval (PrI), −5.6 to 0.8] in children with baseline age >5 years and Z score less than −3 to 0.0 (95% PrI, −2.7 to 2.4) in children with baseline age <2 years and WAZ greater than −1. For HAZ, the corresponding range was −2.3 (95% PrI, −4.9 to 0.3) in children with baseline age >5 years and Z score less than −3 to 0.3 (95% PrI, −3.1 to 3.4) in children with baseline age 2–5 years and HAZ greater than −1.
CONCLUSIONS:We have developed an online tool to calculate reference trajectories in fully suppressed children. The web application could help to define “optimal” growth response and identify children with treatment failure.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>26192393</pmid><doi>10.1097/INF.0000000000000801</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | The Pediatric infectious disease journal, 2015-10, Vol.34 (10), p.e254-e259 |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Anti-HIV Agents - pharmacology Anti-HIV Agents - therapeutic use Child Child, Preschool Female Growth Charts HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - physiopathology HIV Infections - virology HIV-1 - drug effects Humans Infant Male Viral Load - drug effects Waist-Height Ratio |
| title | Growth in Virologically Suppressed HIV-Positive Children on Antiretroviral Therapy: Individual and Population-level References |
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