Growth failure as a prognostic indicator of mortality in pediatric HIV infection
Growth failure as a prognostic indicator of mortality in pediatric HIV infection
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DOI：
10.1542/peds.100.1.e7
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发表时间：
1997-07-01
期刊：
影响因子：
8
通讯作者：
Olness, K
中科院分区：
文献类型：
--
作者：
Berhane, R;Bagenda, D;Olness, K
Objective.研究围产期获得性人类免疫缺陷病毒（HIV）感染对新生儿生长发育的影响，探讨营养状况与HIV感染婴儿死亡率的关系。在乌干达坎帕拉Mulago医院产前门诊就诊的孕妇被纳入研究。所有HIV-1血清阳性（HIV+）妇女所生的活产婴儿和每四个年龄匹配的HIV-1血清阴性（HIV-）妇女所生的活产婴儿均随访25个月。HIV阳性儿童的平均年龄别体重和年龄别身长曲线显著低于HIV阴性儿童和血清转化儿童。84名艾滋病毒阳性婴儿中有45名（54%）在两岁之前死亡，而艾滋病毒阳性和血清转化者的死亡率分别为1.6%和5.6%。出生后第一年平均年龄别体重Z评分低于-1.5的HIV阳性婴儿在25个月前死亡的风险是未感染对照组的近5倍。围产期获得性艾滋病毒感染与早期和进行性生长衰竭有关。生长障碍的严重程度与死亡风险增加有关。应通过对照干预研究评估早期积极营养干预在延缓HIV进展和死亡率方面的效果。
Objective. To study the effect of perinatally acquired human immunodeficiency virus (HIV) on somatic growth and examine the relationship of nutritional status to mortality in HIV-infected infants.Method. Pregnant women attending the antenatal clinic at Mulago hospital in Kampala, Uganda, were enrolled. All live-born babies born to HIV-1 seropositive (HIV+) women, and to every fourth age-matched HIV-1 seronegative (HIV-) woman, were followed for 25 months.Results. The mean weight-for-age and length-for-age curves of HIV+ children were significantly lower than those of HIV- controls and seroeverters. Forty-five (54%) of the 84 HIV+ infants died before their second birthday, as compared with a 1.6% and 5.6% mortality in HIV- and seroeverters. HIV+ infants with an average weight-for-age Z-score below -1.5 in the first year of life have a nearly fivefold risk of dying before 25 months of age compared with noninfected controls.Conclusion. Perinatally acquired HIV infection is associated with early and progressive growth failure. The severity of growth failure is associated with an increased risk of mortality. The effect of early, aggressive nutritional intervention in delaying HIV progression and mortality should be evaluated by controlled intervention studies.