title: The influence of nutritional status on the response to HAART in HIV-infected children in South Africa.
abstract: BACKGROUND
  While the impact of HAART on growth in children is well established, the influence of prior nutritional status on the response to HAART is not well known.
  
  
  METHODS
  A retrospective study was conducted on 120 children in South Africa. Patients were divided into 3 groups (normal, moderately underweight, and severely underweight) based on weight-for-age z-scores (WAZ). Age, weight, height, CD4 cell percentage, and viral load were recorded at initiation of HAART and after 24 months of therapy. Data were analyzed using t-tests, chi tests, and one-way ANOVA.
  
  
  RESULTS
  At baseline, 58% of children were normal weight, 18% moderately underweight, and 23% severely underweight. After 24 months of HAART, WAZ improved significantly in moderately and severely underweight patient groups compared with the normal group. Height-for-age z-scores (HAZ) increased in all 3 groups with severely underweight children gaining more height than normal weight counterparts. Weight-for-height z-scores (WHZ) normalized in the severely underweight group. Mean CD4 cell percentages increased significantly in all 3 groups while viral loads decreased significantly in all groups with no differences among the groups at the end of 24 months of therapy. Of the entire cohort, 75% achieved undetectable HIV RNA viral loads.
  
  
  CONCLUSIONS
  Underlying malnutrition does not adversely affect growth, immunologic or virologic response to HAART in HIV-infected children. Underweight children exhibit an equally robust response to treatment as their well-nourished peers.
authors.affiliation: Department of Pediatrics, Georgetown University Hospital, Washington, DC 20007, USA.
authors.forename: Reené
authors.initials: R
authors.lastname: Naidoo
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rennert
authors.forename: Audrey
authors.initials: A
authors.lastname: Lung
authors.forename: Kimesh
authors.initials: K
authors.lastname: Naidoo
authors.forename: Neil
authors.initials: N
authors.lastname: McKerrow
mesh_terms: D000367:Age Factors; D000704:Analysis of Variance; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D016009:Chi-Square Distribution; D015362:Child Nutrition Disorders / Q000453:epidemiology / Q000821:virology*; D002675:Child, Preschool; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D013851:Thinness / Q000453:epidemiology / Q000821:virology; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents