Growth in human immunodeficiency virus type 1-infected children treated with protease inhibitors.
To determine the long-term impact of antiretroviral treatment (ART) including a protease inhibitor (PI) on growth in children infected with the human immunodeficiency virus type I (HIV-1), a prospective multi-centre study was conducted in Switzerland on HIV-1-infected children treated with ritonavir (350 mg/m2 twice a day) or nelfinavir (20-30 mg/kg three times a day) in addition to two nucleoside reverse transcriptase inhibitors. Length or height of HlV-1-infected children from before (weeks -72, -48, -24, and 0) and after (weeks +24, +48, and +72) introducing a PI to the ART were compared. To allow for age- and gender-independent assessment, values were expressed in standard deviations from the mean. Complete data sets on body length were available for 44 children after 72 weeks of treatment with a PI. Preceding initiation of a PI, there was an overall decline in growth to -0.3 SD. Following start of a PI, an increase in growth was noted from weeks 0 to +24 (+0.33 SD, P=0.02) and from weeks +48 to +72 (+0.21 SD, P=0.03). The increase in growth was restricted to children with stunting before a PI was introduced (P=0.03), and was more marked in children younger than 3 years of age.


CONCLUSIONS
children infected with human immunodeficiency virus type 1 showed catch-up growth after addition of a protease inhibitor to their antiretroviral treatment, but this phenomenon was observed almost exclusively in children under 3 years of age.
Steiner
F
F
Division of Infectious Diseases, University Children's Hospital, Zurich, Switzerland.
Kind
C
C
Aebi
C
C
Wyler-Lazarevitch
C A
CA
Cheseaux
J J
JJ
Rudin
C
C
Molinari
L
L
Nadal
D
D
D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D006128:Growth / Q000187:drug effects*; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D019438:Ritonavir / Q000627:therapeutic use
D017320:HIV Protease Inhibitors; D019438:Ritonavir