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http://hdl.handle.net/123456789/1890
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| Title: | Growth, immune and viral responses in HIV infected African children receiving highly active antiretroviral therapy: a prospective cohort study |
| Authors: | Musoke, Philippa M.
Mudiope, Peter
Barlow-Mosha, Linda N
Ajuna, Patrick
Bagenda, Danstan
Mubiru, Michael M.
Tylleskar, Thorkild
Fowler, Mary G. |
| Keywords: | HIV/AIDS
Paediatrics
Antiretroviral therapy
Children
HAART
Africa |
| Issue Date: | 2010 |
| Publisher: | BioMed Central |
| Citation: | Musoke, P.M., Mudiope, P., Barlow-Mosha, L.N., Ajuna, P., Bagenda, D., Mubiru, M.M., Tylleskar, T., Fowler, M.G. (2010). Growth, immune and viral responses in HIV infected African children receiving highly active antiretroviral therapy: a prospective cohort study. BMC Pediatrics, 10(26) |
| Abstract: | Background: Scale up of paediatric antiretroviral therapy in resource limited settings continues despite limited
access to routine laboratory monitoring. We documented the weight and height responses in HIV infected
Ugandan children on highly active antiretroviral therapy and determined clinical factors associated with successful
treatment outcomes.
Methods: A prospective cohort of HIV infected children were initiated on HAART and followed for 48 weeks. Body
mass index for age z scores(BAZ), weight and height-for-age z scores (WAZ & HAZ) were calculated: CD4 cell %
and HIV-1 RNA were measured at baseline and every 12 weeks. Treatment outcomes were classified according to;
both virological and immunological success (VS/IS), virological failure and immunological success (VF/IS). virological
success and immunological failure (VS/IF) and both virological and immunological failure (VF/IF).
Results: From March 2004 until May 2006, 124 HIV infected children were initiated on HAART. The median age
(IQR) was 5.0 years (2.1 - 7.0) and 49% (61/124) were female. The median [95% confidence interval (CI)] BAZ, WAZ
and HAZ at baseline were 0.29 (-2.9, -1.2), -1.2 (-2.1, -0.5) and -2.06 (-2.9, -1.2) respectively. Baseline median CD4 cell
% and log10 HIV-1 RNA were; 11.8% (7.5-18.0) and 5.6 (5.2-5.8) copies/ml. By 48 weeks, mean WAZ and HAZ in the
VF/IS group, which was younger, increased from - 0.98 (SD 1.7) to + 1.22 (SD 1.2) and from -1.99 (1.7) to + 0.76
(2.4) respectively. Mean increase in WAZ and HAZ in the VS/IF group, an older group was modest, from -1.84 (1.3)
to - 0.41 (1.2) and -2.25 (1.2) to -1.16 (1.3) respectively. Baseline CD4 cell % [OR 6.97 95% CI (2.6 -18.6)], age [OR 4.6
95% CI (1.14 -19.1)] and WHO clinical stage [OR 3.5 95%CI (1.05 -12.7)] were associated with successful treatment
outcome.
Conclusions: HIV infected Ugandan children demonstrated a robust increase in height and weight z scores during
the first 48 weeks of HAART, including those who failed to completely suppress virus. Older children initiating
HAART with severe immune suppression were less likely to achieve a successful treatment outcome. These data
emphasize the importance of initiating HAART early to ensure adequate immune and growth responses. |
| URI: | http://www.biomedcentral.com/1471-2431/10/56
http://hdl.handle.net/123456789/1890 |
| ISSN: | 1471-2431 |
| Appears in Collections: | Research Articles (Health-Sciences)
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| musoke-chs-res.pdf | | 310Kb | Adobe PDF | View/Open |
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