title: Age-specific and sex-specific weight gain norms to monitor antiretroviral therapy in children in low-income and middle-income countries.
abstract: BACKGROUND
  Viral load and CD4% are often not available in resource-limited settings for monitoring children's responses to antiretroviral therapy (ART). We aimed to construct normative curves for weight gain at 6, 12, 18, and 24 months following initiation of ART in children, and to assess the association between poor weight gain and subsequent responses to ART.
  
  
  METHODS
  Analysis of data from HIV-infected children younger than 10 years old from African and Asian clinics participating in the International epidemiologic Databases to Evaluate AIDS.
  
  
  METHODS
  The generalized additive model for location, scale, and shape was used to construct normative percentile curves for weight gain at 6, 12, 18, and 24 months following ART initiation. Cox proportional models were used to assess the association between lower percentiles (< 50th) of weight gain distribution at the different time points and subsequent death, virological suppression, and virological failure.
  
  
  RESULTS
  Among 7173 children from five regions of the world, 45% were underweight at baseline. Weight gain below the 50th percentile at 6, 12, 18, and 24 months of ART was associated with increased risk of death, independent of baseline characteristics. Poor weight gain was not associated with increased hazards of virological suppression or virological failure.
  
  
  CONCLUSIONS
  Monitoring weight gain on ART using age-specific and sex-specific normative curves specifically developed for HIV-infected children on ART is a simple, rapid, sustainable tool that can aid in the identification of children who are at increased risk of death in the first year of ART.
authors.affiliation: aDivision of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio bDepartment of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA cDepartment of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa dSchool of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA eSchool of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa fInstitute of Social and Preventive Medicine, University of Bern, Switzerland gTumbi Regional Referral Hospital, Kibaha hMorogoro Regional Hospital, Morogoro, Tanzania iUniversity of New South Wales, The Kirby Institute for Infection and Immunity in Society, Darlinghurst, New South Wales, Australia jChiangrai Prachanukroh Hospital, Chiangrai, Thailand kInstitut de Santé Publique Epidemiologie et Développement, Université Bordeaux lInserm, Centre Inserm U897 'Epidémiologie et Biostatistique', Bordeaux, France mCentre National Hospitalier, Universitaire Hubert K. Maga, Cotonou, Bénin nRTI International, Biostatistics and Epidemiology, Research Triangle Park, North Carolina, USA.
authors.forename: Marcel
authors.initials: M
authors.lastname: Yotebieng
authors.forename: Tammy
authors.initials: T
authors.lastname: Meyers
authors.forename: Frieda
authors.initials: F
authors.lastname: Behets
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: Davies
authors.forename: Olivia
authors.initials: O
authors.lastname: Keiser
authors.forename: Kapella Zacharia
authors.initials: KZ
authors.lastname: Ngonyani
authors.forename: Rita E
authors.initials: RE
authors.lastname: Lyamuya
authors.forename: Azar
authors.initials: A
authors.lastname: Kariminia
authors.forename: Rawiwan
authors.initials: R
authors.lastname: Hansudewechakul
authors.forename: Valeriane
authors.initials: V
authors.lastname: Leroy
authors.forename: Sikiratou
authors.initials: S
authors.lastname: Koumakpai
authors.forename: Jamie
authors.initials: J
authors.lastname: Newman
authors.forename: Annelies
authors.initials: A
authors.lastname: Van Rie
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011203:Poverty; D016016:Proportional Hazards Models; D012016:Reference Values; D019562:Viral Load; D015430:Weight Gain
chemical_list: D019380:Anti-HIV Agents