Title
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Six-month gain in weight, height, and CD4 predict subsequent antiretroviral treatment responses in HIV-infected South African children
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Author
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Abstract
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Objectives: Construct percentile curves for 6-month gain in weight, height, CD4 cell count, and CD4 percentage (CD4%) in children initiating ART, and to assess the association between lower percentiles and Subsequent ART responses. Design: Cohort of 1394 HIV-infected children initiating ART between April 2004 and March 2008, Johannesburg, South Africa Methods: The generalized additive model for location, scale, and shape was used to construct percentile curves for 6-month gain in weight, height, CD4 cell Count, and CD4%. Cox proportional models were used to assess the association between lower percentiles of each distribution and death, virological Suppression, and treatment failure between 6 to 36 months post-ART initiation. Results: Lower percentiles for gain in weight, CD4, and CD4% count after 6 months of ART, but not height, were associated with poor Subsequent treatment Outcomes independent of baseline characteristics, with increasing strength of association as percentiles decreased. Age-specific 6-month post-ART weight gain in our cohort Was Substantially higher compared with 6-month weight gain in non-HIV-infected American children of the Fels Institute cohort and the attained weight-for-age at 6 months post-ART plotted on WHO weight-for-age growth charts were not associated with subsequent treatment Outcomes. Conclusion: Gain in CD4%. in the first 6 months of ART was the best predictor of poor subsequent ART Outcomes. In areas with limited access to CD4%, weight gain post-ART using our newly developed reference distributions for HIV-infected children on ART is a good alternative to CD4%, and clearly superior to the commonly used 'Road-to-Health' weight-for-age charts. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins |
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Language
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English
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Source (journal)
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AIDS. - London
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Publication
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London
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2010
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ISSN
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0269-9370
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DOI
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10.1097/QAD.0B013E328332D5CA
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Volume/pages
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24
:1
(2010)
, p. 139-146
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ISI
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000272917900018
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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