TY - JOUR
T1 - Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis
AU - The Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration
AU - Jesson, Julie
AU - Crichton, Siobhan
AU - Quartagno, Matteo
AU - Yotebieng, Marcel
AU - Abrams, Elaine J.
AU - Chokephaibulkit, Kulkanya
AU - Le Coeur, Sophie
AU - Aké-Assi, Marie Hélène
AU - Patel, Kunjal
AU - Pinto, Jorge
AU - Paul, Mary
AU - Vreeman, Rachel
AU - Davies, Mary Ann
AU - Ben-Farhat, Jihane
AU - Van Dyke, Russell
AU - Judd, Ali
AU - Mofenson, Lynne
AU - Vicari, Marissa
AU - Seage, George
AU - Bekker, Linda Gail
AU - Essajee, Shaffiq
AU - Gibb, Diana
AU - Penazzato, Martina
AU - Collins, Intira Jeannie
AU - Wools-Kaloustian, Kara
AU - Slogrove, Amy
AU - Powis, Kate
AU - Williams, Paige
AU - Matshaba, Mogomotsi
AU - Thahane, Lineo
AU - Nyasulu, Phoebe
AU - Lukhele, Bhekumusa
AU - Mwita, Lumumba
AU - Kekitiinwa-Rukyalekere, Adeodata
AU - Wanless, Sebastian
AU - Goetghebuer, Tessa
AU - Thorne, Claire
AU - Warszawski, Josiane
AU - Galli, Luisa
AU - van Rossum, Annemarie M.C.
AU - Giaquinto, Carlo
AU - Marczynska, Magdalena
AU - Marques, Laura
AU - Prata, Filipa
AU - Ene, Luminita
AU - Okhonskaya, Lyuba
AU - Navarro, Marisa
AU - Frick, Antoinette
AU - Naver, Lars
AU - Kahlert, Christian
N1 - Funding Information:
This work was supported by the International AIDS Society – Collaborative Initiative for Paediatric HIV Education & Research (IAS-CIPHER, http://www.iasociety.org/CIPHER), which is made possible through funding from CIPHER Founding Sponsor ViiV Healthcare (https://www.viivhealthcare.com) and Janssen (http://www.janssen.com). The authors thank all participating networks, clinics, clinic personnel and patients who contributed data and made the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration Adolescent Project possible. We also thank the CIPHER Executive Committee, the CIPHER Steering Committee and the Project Oversight Group. The study was sponsored by the International AIDS Society-CIPHER.
Funding Information:
Individual networks contributing to the CIPHER Cohort Collaboration have received the following financial support: CCASAnet receives funding from the United States (US) National Institutes of Health (NIH) (grant number U01AI069923); IeDEA Asia Pacific receives funding from the US NIH (grant number U01AI069907); IeDEA Central Africa receives funding from the US NIH (grant number U01AI096299); IeDEA East Africa receives funding from the US NIH (grant number U01A1069911); IeDEA Southern Africa receives funding from the US NIH (grant number U01AI069924); IeDEA West Africa receives funding from the US NIH (grant number U01AI069919); overall support for the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT) was provided by the National Institute of Allergy and Infectious Diseases (NIAID) with co‐funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institute of Mental Health (NIMH), all components of the NIH, under Award Numbers UM1AI068632 (IMPAACT LOC), UM1AI068616 (IMPAACT SDMC) and UM1AI106716 (IMPAACT LC), and by NICHD contract number HHSN275201800001I; PHACS receives funding from the US NIH (grant numbers U01 HD052102 and U01 HD052104); the Optimal Models (ICAP at Columbia University) project was supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (cooperative agreement numbers: 5U62PS223540 and 5U2GPS001537); EPPICC receives funding from the PENTA Foundation ( http://penta‐id.org ), and received support from the European Union's Horizon 2020 research and innovation programme under grant agreement no 825579 for the REACH study. The MRC Clinical Trials Unit at UCL is supported by the Medical Research Council (programme number MC_UU_12023/26). Individual cohorts contributing to EPPICC receive the following support: the ATHENA database is maintained by Stichting HIV Monitoring and supported by a grant from the Dutch Ministry of Health, Welfare and Sport through the Centre for Infectious Disease Control of the National Institute for Public Health and the Environment. CoRISPE‐cat receives financial support from the Instituto de Salud Carlos III through the Red Temática de Investigación Cooperativa en Sida (grant numbers RED RIS RD06/0006/0035 yRD06/0006/0021). Financial support for CoRISpeS and Madrid Cohort was provided by the Instituto de Salud Carlos III through the Red Tematica de Investigacion Cooperativa en Sida (RED‐RIS) project (grant number RD16/0025/0019) as part of the Plan R+D+I and cofinanced by ISCIII‐Subdireccion General de Evaluación and Fondo Europeo de Desarrollo Regional (FEDER). FIS PI19/01530. The Swiss HIV Cohort Study is supported by the Swiss National Science Foundation (grant number: 177499) and by the SHCS Research Foundation. The Thai cohort study was funded by the Global Fund to fight AIDS, Tuberculosis and Malaria, Thailand (PR‐A‐N‐008); Oxfam Great Britain, Thailand (THAA51); Ministry of Public Health, Thailand; and Institut de Recherche pour le Développement (IRD), France. Ukraine Paediatric HV Cohort is supported by the PENTA Foundation. CHIPS is funded by the NHS (London Specialized Commissioning Group) and has received additional support from Bristol‐Myers Squibb, Boehringer Ingelheim, GlaxoSmithKline, Roche, Abbott and Gilead Sciences. The MRC Clinical Trials Unit at UCL is supported by the Medical Research Council (programme number MC_UU_12023/26).
Funding Information:
The authors thank all participating networks, clinics, clinic personnel and patients who contributed data and made the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) Global Cohort Collaboration Adolescent Project possible. We also thank the CIPHER Executive Committee, the CIPHER Steering Committee and the Project Oversight Group. The study was sponsored by the International AIDS Society‐CIPHER.
Funding Information:
MV's work at CIPHER is funded through Unrestricted Educational grants received from ViiV Healthcare and Janssen to the International AIDS Society. AS's institution receives research and travel funding from ViiV Healthcare. CT has received grant funding from ViiV Healthcare via the Penta Foundation (to UCL), and personally from ViiV for participation on an advisory board. AJ reports grants from Abbvie, Bristol Myers Squibb, Gilead, Janssen Pharmaceuticals and ViiV Healthcare through the PENTA Foundation, and from the European and Developing Countries Clinical Trials Partnership, Gilead Sciences, the International AIDS Society, NHS England, Medical Research Council and PENTA Foundation outside the submitted work. All monies were paid to her institution. IJC received grants from the following companies (via her institution) in the past 3 years: ViiV, AbbVie and Gilead.
Funding Information:
This work was supported by the International AIDS Society – Collaborative Initiative for Paediatric HIV Education & Research (IAS‐CIPHER, http://www.iasociety.org/CIPHER ), which is made possible through funding from CIPHER Founding Sponsor ViiV Healthcare ( https://www.viivhealthcare.com ) and Janssen ( http://www.janssen.com ).
Publisher Copyright:
© 2022 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.
PY - 2022/3
Y1 - 2022/3
N2 - Introduction: Adolescents living with HIV are subject to multiple co-morbidities, including growth retardation and immunodeficiency. We describe growth and CD4 evolution during adolescence using data from the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) global project. Methods: Data were collected between 1994 and 2015 from 11 CIPHER networks worldwide. Adolescents with perinatally acquired HIV infection (APH) who initiated antiretroviral therapy (ART) before age 10 years, with at least one height or CD4 count measurement while aged 10–17 years, were included. Growth was measured using height-for-age Z-scores (HAZ, stunting if <-2 SD, WHO growth charts). Linear mixed-effects models were used to study the evolution of each outcome between ages 10 and 17. For growth, sex-specific models with fractional polynomials were used to model non-linear relationships for age at ART initiation, HAZ at age 10 and time, defined as current age from 10 to 17 years of age. Results: A total of 20,939 and 19,557 APH were included for the growth and CD4 analyses, respectively. Half were females, two-thirds lived in East and Southern Africa, and median age at ART initiation ranged from <3 years in North America and Europe to >7 years in sub-Saharan African regions. At age 10, stunting ranged from 6% in North America and Europe to 39% in the Asia-Pacific; 19% overall had CD4 counts <500 cells/mm3. Across adolescence, higher HAZ was observed in females and among those in high-income countries. APH with stunting at age 10 and those with late ART initiation (after age 5) had the largest HAZ gains during adolescence, but these gains were insufficient to catch-up with non-stunted, early ART-treated adolescents. From age 10 to 16 years, mean CD4 counts declined from 768 to 607 cells/mm3. This decline was observed across all regions, in males and females. Conclusions: Growth patterns during adolescence differed substantially by sex and region, while CD4 patterns were similar, with an observed CD4 decline that needs further investigation. Early diagnosis and timely initiation of treatment in early childhood to prevent growth retardation and immunodeficiency are critical to improving APH growth and CD4 outcomes by the time they reach adulthood.
AB - Introduction: Adolescents living with HIV are subject to multiple co-morbidities, including growth retardation and immunodeficiency. We describe growth and CD4 evolution during adolescence using data from the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) global project. Methods: Data were collected between 1994 and 2015 from 11 CIPHER networks worldwide. Adolescents with perinatally acquired HIV infection (APH) who initiated antiretroviral therapy (ART) before age 10 years, with at least one height or CD4 count measurement while aged 10–17 years, were included. Growth was measured using height-for-age Z-scores (HAZ, stunting if <-2 SD, WHO growth charts). Linear mixed-effects models were used to study the evolution of each outcome between ages 10 and 17. For growth, sex-specific models with fractional polynomials were used to model non-linear relationships for age at ART initiation, HAZ at age 10 and time, defined as current age from 10 to 17 years of age. Results: A total of 20,939 and 19,557 APH were included for the growth and CD4 analyses, respectively. Half were females, two-thirds lived in East and Southern Africa, and median age at ART initiation ranged from <3 years in North America and Europe to >7 years in sub-Saharan African regions. At age 10, stunting ranged from 6% in North America and Europe to 39% in the Asia-Pacific; 19% overall had CD4 counts <500 cells/mm3. Across adolescence, higher HAZ was observed in females and among those in high-income countries. APH with stunting at age 10 and those with late ART initiation (after age 5) had the largest HAZ gains during adolescence, but these gains were insufficient to catch-up with non-stunted, early ART-treated adolescents. From age 10 to 16 years, mean CD4 counts declined from 768 to 607 cells/mm3. This decline was observed across all regions, in males and females. Conclusions: Growth patterns during adolescence differed substantially by sex and region, while CD4 patterns were similar, with an observed CD4 decline that needs further investigation. Early diagnosis and timely initiation of treatment in early childhood to prevent growth retardation and immunodeficiency are critical to improving APH growth and CD4 outcomes by the time they reach adulthood.
KW - CD4
KW - HIV
KW - adolescent
KW - cohort studies
KW - growth
KW - perinatally acquired
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U2 - 10.1002/jia2.25871
DO - 10.1002/jia2.25871
M3 - Article
C2 - 35255197
AN - SCOPUS:85125976723
VL - 25
JO - Journal of the International AIDS Society
JF - Journal of the International AIDS Society
SN - 1758-2652
IS - 3
M1 - e25871
ER -