Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand
Por:
Crichton S, Belfrage E, Collins IJ, Doerholt K, Judd A, Le Coeur S, Spoulou V, Scherpbier H, Smit C, Goetghebuer T, Gibb DM, Noguera-Julian A, Navarro ML, Ramos JT, Galli L, Giaquinto C, Thorne C, Ansone S, Marczynska M, Okhonskaia L, Tejada BM, Jourdain G, Decker L, Ene L, Goodall R and Group authorship: The European Pregnancy and Paediatric HIV Cohort Collaboration
Publicada:
1 oct 2019
Ahead of Print:
2 jul 2019
Resumen:
Objective: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. Design: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. Methods: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. Results: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. Conclusion: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age.
Filiaciones:
Crichton S:
MRC Clinical Trials Unit at University College London, London, UK
Belfrage E:
Department of Pediatrics, Karolinska Instritutet and University Hospital, Stockholm, Sweden
Collins IJ:
MRC Clinical Trials Unit at University College London, London, UK
Doerholt K:
St George's University Hospitals NHS Foundation Trust, London, UK
Judd A:
MRC Clinical Trials Unit at University College London, London, UK
Le Coeur S:
French Institute for Demographic Studies (INED), Paris, France
Spoulou V:
Department of Infectious Diseases, University of Athens, Athens, Greece
Scherpbier H:
Amsterdam University Medical Centers, Netherlands
Smit C:
HIV Monitoring Foundation, Amsterdam, Netherlands
Goetghebuer T:
Hopital St Pierre, Brussels, Belgium
Gibb DM:
MRC Clinical Trials Unit at University College London, London, UK
Noguera-Julian A:
Unitat d'Infectologia, Servei de Pediatria, Hospital Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain
Navarro ML:
Hospital General Universitario "Gregorio Marañón", Complutense University, Madrid, Spain
Ramos JT:
Paediatrics Department, Hospital Clínico Universitario San Carlos, Complutense University, Madrid, Spain
Galli L:
Department of Health Sciences, University of Florence, Meyer Children's University Hospital, Italy
Giaquinto C:
Paediatric European Network for the Treatment of AIDS (PENTA), Padova, Italy
Thorne C:
UCL Great Ormond Street Institute of Child Health, UCL, London, UK
Ansone S:
Riga East University Hospital "Latvian Centre on Infectious Diseases", Latvia
Marczynska M:
Medical University of Warsaw, Hospital of Infectious Diseases, Warsaw, Poland
Okhonskaia L:
Republican Hospital of Infectious Diseases, St Petersburg, Russia
Tejada BM:
Department of Obstetrics and Gynecology, and Faculty of Medicine, Geneva, Switzerland
Jourdain G:
Institut de Recherche pour le Developpement (IRD), UMI 174/PHPT, Chiang Mai, Thailand
Decker L:
Institut de Recherche pour le Developpement (IRD), UMI 174/PHPT, Chiang Mai, Thailand
Ene L:
Victor Babes Hospital, Bucharest, Romania
Goodall R:
MRC Clinical Trials Unit at University College London, London, UK
Green Published, hybrid, Green Accepted
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