TY - JOUR
T1 - Age-specific and sex-specific weight gain norms to monitor antiretroviral therapy in children in low-income and middle-income countries
AU - Yotebieng, Marcel
AU - Meyers, Tammy
AU - Behets, Frieda
AU - Davies, Mary Ann
AU - Keiser, Olivia
AU - Ngonyani, Kapella Zacharia
AU - Lyamuya, Rita E.
AU - Kariminia, Azar
AU - Hansudewechakul, Rawiwan
AU - Leroy, Valeriane
AU - Koumakpai, Sikiratou
AU - Newman, Jamie
AU - Van Rie, Annelies
N1 - Publisher Copyright:
© 2014 Wolters Kluwer Health. © Lippincott Williams & Wilkins.
PY - 2015
Y1 - 2015
N2 - 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. Design: 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 . Conclusion: 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 .
AB - 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. Design: 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 . Conclusion: 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 .
KW - Antiretroviral therapy monitoring
KW - CD4<inf>+</inf>
KW - Children
KW - HIV
KW - Lowincome/middle-income countries
KW - Viral load
KW - Weight
UR - http://www.scopus.com/inward/record.url?scp=84928005656&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928005656&partnerID=8YFLogxK
U2 - 10.1097/QAD.0000000000000506
DO - 10.1097/QAD.0000000000000506
M3 - Article
C2 - 25562494
AN - SCOPUS:84928005656
SN - 0269-9370
VL - 29
SP - 101
EP - 109
JO - AIDS
JF - AIDS
IS - 1
ER -