Younger age at HAART initiation is associated with more rapid growth reconstitution

Christine J. McGrath, Michael H. Chung, Barbra A. Richardson, Sarah Benki-Nugent, Danson Warui, Grace C. John-Stewart

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objectives: Patterns of growth following highly active antiretroviral therapy (HAART) administration among children are not well defined. The objective of this study was to determine rates and predictors of growth reconstitution among children on HAART. Methods: A study was conducted among HIV-1-infected children initiating HAART at an HIV treatment clinic in Kenya. Kaplan-Meier survival curves and Cox proportional hazards regression models compared catch-up growth (Z-score ≥0) at 12 months post-HAART. Multivariate linear mixed-effects models determined rates and predictors of growth following HAART. Results: One hundred and seventy-three HIV-1-infected children initiated HAART with a median age of 4.7 years [interquartile range (IQR) 2.4, 7.0]. At baseline, children below 3 years had lower weight-for-age (WAZ) and weight-for-height (WHZ) Z-scores than children 3-5 and 6-10 years (WAZ: P = 0.03; WHZ: P = 0.006). Adjusting for baseline growth, children below 3 years were two to three-fold more likely to attain population age-norms (Z-score = 0) than 6-10 years (WAZ: P = 0.055; WHZ: P = 0.005) at 12 months post-HAART. After adjustment, children below 3 years had higher increases in WAZ and WHZ following HAART than 6-10 years (WAZ: P = 0.006; WHZ: P = 0.005). Children at WHO stage at least 3 at baseline experienced more rapid WHZ reconstitution (P = 0.002). Food supplementation while on HAART was associated with increased monthly gains in weight indices (WAZ: P = 0.001; WHZ: P = 0.005), and multivitamins were associated with greater increases in height (P < 0.01). Conclusion: Following HAART initiation, younger children had more rapid catch-up to the population-average weight of their peers than older children, demonstrating growth benefit of earlier HAART. In addition to HAART, food supplementation and multivitamins may also accelerate growth reconstitution.

Original languageEnglish (US)
Pages (from-to)345-355
Number of pages11
JournalAIDS
Volume25
Issue number3
DOIs
StatePublished - Jan 28 2011
Externally publishedYes

Fingerprint

Highly Active Antiretroviral Therapy
Growth
Dietary Supplements
Weights and Measures
HIV-1
Kenya
Kaplan-Meier Estimate
Secondary Prevention
Proportional Hazards Models
Population
Weight Gain
HIV

Keywords

  • growth
  • HAART
  • HIV
  • nutritional supplementation
  • pediatrics
  • sub-Saharan Africa

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

McGrath, C. J., Chung, M. H., Richardson, B. A., Benki-Nugent, S., Warui, D., & John-Stewart, G. C. (2011). Younger age at HAART initiation is associated with more rapid growth reconstitution. AIDS, 25(3), 345-355. https://doi.org/10.1097/QAD.0b013e32834171db

Younger age at HAART initiation is associated with more rapid growth reconstitution. / McGrath, Christine J.; Chung, Michael H.; Richardson, Barbra A.; Benki-Nugent, Sarah; Warui, Danson; John-Stewart, Grace C.

In: AIDS, Vol. 25, No. 3, 28.01.2011, p. 345-355.

Research output: Contribution to journalArticle

McGrath, CJ, Chung, MH, Richardson, BA, Benki-Nugent, S, Warui, D & John-Stewart, GC 2011, 'Younger age at HAART initiation is associated with more rapid growth reconstitution', AIDS, vol. 25, no. 3, pp. 345-355. https://doi.org/10.1097/QAD.0b013e32834171db
McGrath CJ, Chung MH, Richardson BA, Benki-Nugent S, Warui D, John-Stewart GC. Younger age at HAART initiation is associated with more rapid growth reconstitution. AIDS. 2011 Jan 28;25(3):345-355. https://doi.org/10.1097/QAD.0b013e32834171db
McGrath, Christine J. ; Chung, Michael H. ; Richardson, Barbra A. ; Benki-Nugent, Sarah ; Warui, Danson ; John-Stewart, Grace C. / Younger age at HAART initiation is associated with more rapid growth reconstitution. In: AIDS. 2011 ; Vol. 25, No. 3. pp. 345-355.
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