title: Early Height and Weight Changes in Children Using Cotrimoxazole Prophylaxis With Antiretroviral Therapy.
abstract: The growth benefits of cotrimoxazole during early antiretroviral therapy (ART) are not well characterized.
  
  
  
  Individuals enrolled in the Therapeutics Research, Education, and AIDS Training in Asia Pediatric HIV Observational Database were included if they started ART at ages 1 month-14 years and had both height and weight measurements available at ART initiation (baseline). Generalized estimating equations were used to identify factors associated with change in height-for-age z-score (HAZ), follow-up HAZ ≥ -2, change in weight-for-age z-score (WAZ), and follow-up WAZ ≥ -2.
  
  
  
  A total of 3217 children were eligible for analysis. The adjusted mean change in HAZ among cotrimoxazole and non-cotrimoxazole users did not differ significantly over the first 24 months of ART. In children who were stunted (HAZ < -2) at baseline, cotrimoxazole use was not associated with a follow-up HAZ ≥ -2. The adjusted mean change in WAZ among children with a baseline CD4 percentage (CD4%) >25% became significantly different between cotrimoxazole and non-cotrimoxazole users after 6 months of ART and remained significant after 24 months (overall P < .01). Similar changes in WAZ were observed in those with a baseline CD4% between 10% and 24% (overall P < .01). Cotrimoxazole use was not associated with a significant difference in follow-up WAZ in children with a baseline CD4% <10%. In those underweight (WAZ < -2) at baseline, cotrimoxazole use was associated with a follow-up WAZ ≥ -2 (adjusted odds ratio, 1.70 vs not using cotrimoxazole [95% confidence interval, 1.28-2.25], P < .01). This association was driven by children with a baseline CD4% ≥10%.
  
  
  
  Cotrimoxazole use is associated with benefits to WAZ but not HAZ during early ART in Asian children.
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: Boettiger
authors.affiliation: Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
authors.forename: Dina
authors.initials: D
authors.lastname: Muktiarti
authors.affiliation: Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
authors.forename: Nia
authors.initials: N
authors.lastname: Kurniati
authors.affiliation: Children's Hospital 1, Ho Chi Minh City, Vietnam.
authors.forename: Khanh H
authors.initials: KH
authors.lastname: Truong
authors.affiliation: Y.R. Gaitonde Center for AIDS Research and Education Medical Centre, Chennai, India.
authors.forename: Suneeta
authors.initials: S
authors.lastname: Saghayam
authors.affiliation: National Centre for HIV/AIDS, Dermatology, and Sexually Transmitted Diseases, Phnom Penh, Cambodia.
authors.forename: Penh Sun
authors.initials: PS
authors.lastname: Ly
authors.affiliation: Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
authors.forename: Rawiwan
authors.initials: R
authors.lastname: Hansudewechakul
authors.affiliation: National Hospital of Pediatrics, Hanoi.
authors.forename: Lam
authors.initials: L
authors.lastname: Van Nguyen
authors.affiliation: Children's Hospital 2, Ho Chi Minh City, Vietnam.
authors.forename: Viet Chau
authors.initials: VC
authors.lastname: Do
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Chiang Mai University and Research Institute for Health Sciences, Chiang Mai.
authors.forename: Tavitiya
authors.initials: T
authors.lastname: Sudjaritruk
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen.
authors.forename: Pagakrong
authors.initials: P
authors.lastname: Lumbiganon
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok.
authors.forename: Kulkanya
authors.initials: K
authors.lastname: Chokephaibulkit
authors.affiliation: HIV Netherlands Australia Thailand Research Collaboration, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
authors.forename: Torsak
authors.initials: T
authors.lastname: Bunupuradah
authors.affiliation: Hospital Raja Perempuan Zainab II, Kelantan, Malaysia.
authors.forename: Nik Khairulddin
authors.initials: NK
authors.lastname: Nik Yusoff
authors.affiliation: Sanglah Hospital, Udayana University, Bali, Indonesia.
authors.forename: Dewi Kumara
authors.initials: DK
authors.lastname: Wati
authors.affiliation: Pediatric Institute, Hospital Kuala Lumpur, Kuala Lumpur.
authors.forename: Kamarul Azahar
authors.initials: KA
authors.lastname: Mohd Razali
authors.affiliation: Hospital Likas, Kota Kinabalu.
authors.forename: Moy Siew
authors.initials: MS
authors.lastname: Fong
authors.affiliation: Penang Hospital, Penang, Malaysia.
authors.forename: Revathy A
authors.initials: RA
authors.lastname: Nallusamy
authors.affiliation: TREAT Asia/amfAR-Foundation for AIDS Research, Bangkok, Thailand.
authors.forename: Annette H
authors.initials: AH
authors.lastname: Sohn
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, Australia.
authors.forename: Azar
authors.initials: A
authors.lastname: Kariminia
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001208:Asia; D001827:Body Height / Q000187:drug effects*; D001835:Body Weight / Q000187:drug effects*; D002648:Child; D002657:Child Development / Q000187:drug effects; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
keywords: antiretroviral therapy; children; cotrimoxazole; height; weight