title: Risk Factors for Growth Retardation in HIV-infected Senegalese Children on Antiretroviral Treatment: The ANRS 12279 MAGGSEN Pediatric Cohort Study.
abstract: To describe prevalence and risk factors for wasting and stunting among HIV-infected children with a median duration of 3 years of antiretroviral therapy (ART) at the time of their enrollment in the cohort study.
  
  
  
  Wasting and stunting at ART initiation and enrollment were defined as weight-for-height/body mass index-for-age Z scores < -2 and height-for-age Z scores < -2, respectively. Logistic regression was used to assess risk factors for wasting and stunting. Main predictive factors were age at enrollment, nutritional status and age (< or ≥5 years) at ART initiation and ART duration (< or ≥3 years on first-line, or ≥3 years including a switch to second-line ART).
  
  
  
  Two hundred forty-four children 2-16 years of age were enrolled. Overall, wasting and stunting prevalence dropped off consistently in children 2-10 years of age, between ART initiation and enrollment, while it remained at high levels, 52% and 42%, respectively, in children 10-16 years of age. Risk factors for wasting at enrollment were ART duration of ≥3 years including a switch to second-line [adjusted odds ratio (aOR): 3.9, 95% confidence interval (CI): 1.7-8.9] and wasting at ART initiation (aOR: 2.7, 95% CI: 1.4-5.2). The risk factor for stunting at enrollment was stunting at ART initiation (aOR: 11.6, 95% CI: 5.4-25.0), independent of ART duration.
  
  
  
  Malnutrition at the time of ART initiation was the main predictor of malnutrition at enrollment among HIV-infected children on ART. Longer duration on ART had no overall protective effect on wasting and stunting. Growth and virologic monitoring are of utmost importance in the comprehensive care of children with HIV infection.
authors.affiliation: From the *Institut de Recherche pour le Développement (IRD), UMI233 IRD, INSERM U1175, Université de Montpellier, Montpellier, France; †Centre Hospitalier National d'Enfants Albert Royer, Dakar, Senegal; and ‡Synergie Pour l'Enfance, Centre Hospitalier Roi Baudouin, Guediawaye, Senegal.
authors.forename: Cecile
authors.initials: C
authors.lastname: Cames
authors.forename: Lea
authors.initials: L
authors.lastname: Pascal
authors.forename: Aminata
authors.initials: A
authors.lastname: Diack
authors.forename: Helene
authors.initials: H
authors.lastname: Mbodj
authors.forename: Baly
authors.initials: B
authors.lastname: Ouattara
authors.forename: Ndeye Rama
authors.initials: NR
authors.lastname: Diagne
authors.forename: Ndeye Fatou
authors.initials: NF
authors.lastname: Diallo
authors.forename: Philippe
authors.initials: P
authors.lastname: Msellati
authors.forename: Ngagne
authors.initials: N
authors.lastname: Mbaye
authors.forename: Haby
authors.initials: H
authors.lastname: Sy Signate
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006130:Growth Disorders / Q000150:complications* / Q000453:epidemiology*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007223:Infant; D009748:Nutrition Disorders / Q000453:epidemiology; D012307:Risk Factors; D012675:Senegal / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents