Growth parameters in HIV-vertically-infected adolescents on antiretroviral therapy in Rio de Janeiro, Brazil.
BACKGROUND
Growth failure in HIV-infected children is an important factor in either initiating or changing antiretroviral therapy (ART). This study assesses the impact of HIV infection on growth parameters of adolescents who acquired HIV vertically.


METHODS
This retrospective, longitudinal study involved adolescents aged 10-20 years with vertically-acquired HIV infection who were followed up in one of the three main referral centres for paediatric HIV/AIDS in Rio de Janeiro, Brazil. Length, weight and variables related to demographic, clinical and laboratory issues were analysed.


RESULTS
108 subjects were enrolled. Median age was 12.7 years, median duration of follow-up was 97.2 months and 61 (56.5%) were female. The difference between the baseline and final weight Z-scores was -0.31 (p=0.02). Patients with final weight Z-scores < or = -2 used more ART regimens (average 4.13) than those with Z-scores > -2 (average 2.90, p<0.01) and also had a lower final CD4+ cell percentage--average 19% vs 24% (p<0.01), respectively. The difference between baseline and final-height Z-scores was -0.27 (p<0.01). Several factors were associated with a final-height Z-score < or = -2: clinical stage C during follow-up (RR 1.60, 95% CI 1.11-2.31), chronic diarrhoea during follow-up (RR 2.02, 95% CI 1.04-3.90), HAART use (RR 1.41, 95% CI 1.16-1.71), number of ART regimens (p<0.01) and final CD4+ cell percentage (p<0.01). In multivariate analysis, presentation in clinical stage C during follow-up was the only significant variable (OR 4.04, 95% CI 1.23-13.28).


CONCLUSIONS
Even on HAART, HIV-infected adolescents have lower growth parameters than the normal population and this is associated with a worse prognosis.
Buonora
Sibelle
S
Department of Pediatrics, Federal University of Rio de Janeiro, Brazil.
Nogueira
Susie
S
Pone
Marcus Vinicius
MV
Aloé
Marisa
M
Oliveira
Ricardo Hugo
RH
Hofer
Cristina
C
D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001827:Body Height; D001835:Body Weight; D001938:Brazil; D018791:CD4 Lymphocyte Count; D002648:Child; D003906:Developing Countries; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000821:virology*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D012189:Retrospective Studies