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ART reversed stunting in children with HIV when started early
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Indian children living with HIV showed significant weight and height improvements with antiretroviral therapy when it commenced before 5 years of age, according to the results of retrospective cohort analysis presented at the 2013 International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur, Malaysia.
The cohort included 466 children (201 girls, mean age of 7 years; 265 boys, mean age of 7.6 years), most of whom were in an advanced stage of HIV at the initiation of treatment (64.6% in WHO clinical stage III or IV; 87.38% with severe or advanced immunodeficiency). Ninety-eight percent of the children were perinatally infected.
Height and weight z scores were calculated with WHO growth charts for children. Median scores were –2.43 to –1.67 (P<.001) at baseline and increased to –2.52 to –2.23 (P=.013) after 60 months of ART. The least gain was seen in children aged at least 5 years (P=.187).Catch-up growth post-treatment was measured using a mixed-model method (adjusted for gender, weight and height z scores, clinical and immunodeficiency stage and starting age) and indicated significant growth improvements with ART (P<.001), with weight improving more than height.
“Delays in diagnosis and ART initiation result in irreversible growth retardation among [children living with HIV],” researchers wrote. “Whether ART started immediately after diagnosis — irrespective of clinical and immune stage — would prevent growth failure in children needs further investigation.”
For more information:
Parchure R. Abstract MOPE048. Presented at: 7th IAS Conference on HIV Pathogenesis, Treatment and Prevention; June 30-July 03, 2013; Kuala Lumpur, Malaysia.