title: The use of second-generation antipsychotics and the changes in physical growth in children and adolescents with perinatally acquired HIV.
abstract: Second-generation antipsychotics (SGAs) are increasingly prescribed to treat psychiatric symptoms in pediatric patients infected with HIV. We examined the relationship between prescribed SGAs and physical growth in a cohort of youth with perinatally acquired HIV-1 infection. Pediatric AIDS Clinical Trials Group (PACTG), Protocol 219C (P219C), a multicenter, longitudinal observational study of children and adolescents perinatally exposed to HIV, was conducted from September 2000 until May 2007. The analysis included P219C participants who were perinatally HIV-infected, 3-18 years old, prescribed first SGA for at least 1 month, and had available baseline data prior to starting first SGA. Each participant prescribed an SGA was matched (based on gender, age, Tanner stage, baseline body mass index [BMI] z score) with 1-3 controls without antipsychotic prescriptions. The main outcomes were short-term (approximately 6 months) and long-term (approximately 2 years) changes in BMI z scores from baseline. There were 236 participants in the short-term and 198 in the long-term analysis. In linear regression models, youth with SGA prescriptions had increased BMI z scores relative to youth without antipsychotic prescriptions, for all SGAs (short-term increase = 0.192, p = 0.003; long-term increase = 0.350, p < 0.001), and for risperidone alone (short-term = 0.239, p = 0.002; long-term = 0.360, p = 0.001). Participants receiving both protease inhibitors (PIs) and SGAs showed especially large increases. These findings suggest that growth should be carefully monitored in youth with perinatally acquired HIV who are prescribed SGAs. Future research should investigate the interaction between PIs and SGAs in children and adolescents with perinatally acquired HIV infection.
authors.affiliation: Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: Suad
authors.initials: S
authors.lastname: Kapetanovic
authors.forename: Lisa
authors.initials: L
authors.lastname: Aaron
authors.forename: Grace
authors.initials: G
authors.lastname: Montepiedra
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Sirois
authors.forename: James M
authors.initials: JM
authors.lastname: Oleske
authors.forename: Kathleen
authors.initials: K
authors.lastname: Malee
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Pearson
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Nichols
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Garvie
authors.forename: John
authors.initials: J
authors.lastname: Farley
authors.forename: Molly L
authors.initials: ML
authors.lastname: Nozyce
authors.forename: Mark
authors.initials: M
authors.lastname: Mintz
authors.forename: Paige L
authors.initials: PL
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D041923:Adolescent Development / Q000187:drug effects; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001827:Body Height / Q000187:drug effects; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D016022:Case-Control Studies; D002648:Child; D002657:Child Development / Q000187:drug effects; D002675:Child, Preschool; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D015497:HIV-1; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008137:Longitudinal Studies; D001523:Mental Disorders / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents