Global variations in pubertal growth spurts in adolescents living with perinatal HIV.
Global variations in pubertal growth spurts in adolescents living with perinatal HIV.
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DOI：
10.1097/qad.0000000000003602
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发表时间：
2023-08-01
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描述围产儿获得性艾滋病毒（ALWPHIV）感染的青少年在抗逆转录病毒治疗（ART）后的青春期生长突增。1994年至2015年在CIPHER全球队列合作中收集的观测数据。开始抗逆转录病毒治疗年龄小于10年且至少4次身高测量年龄至少8年的ALWPHIV被纳入。通过平移和旋转的超级拼版（SITAR）模型，用参数表示生长突增的时间和强度，分别按性别描述生长。探讨了地区、ART方案、年龄、ART起始（基线）时的年龄比身高（HAZ）、bmi年龄比z分数（BMIz）和年龄10岁以及SITAR参数之间的关系。包括4723例ALWPHIV: 51%来自东非和南部非洲（不包括博茨瓦纳和南非），17%来自博茨瓦纳和南非，6%来自西非和中非，11%来自欧洲和北美，11%来自亚太地区，4%来自中南美洲和加勒比地区。在撒哈拉以南地区，经济增长突增的时间较晚，也最不强烈。在女性中，较年长的基线年龄和较低的基线bmi与较晚和更强烈的生长突增有关；较低的HAZ与较晚的生长突增有关。在男性中，较年长的基线年龄和较低的HAZ与较晚和较弱的生长突增有关；然而，基线HAZ与时间之间的关系因年龄而异。10岁时较低的HAZ和BMIz与较晚和较不强烈的两性生长突增有关。在年龄较大或已经发育迟缓时开始抗逆转录病毒治疗的艾滋病毒感染者更有可能推迟青春期的生长。长期随访对于了解发育迟缓的影响很重要。
To describe pubertal growth spurts among adolescents living with perinatally acquired HIV (ALWPHIV) on antiretroviral therapy (ART). Observational data collected from 1994 to 2015 in the CIPHER global cohort collaboration. ALWPHIV who initiated ART age less than 10 years with at least four height measurements age at least 8 years were included. Super Imposition by Translation And Rotation (SITAR) models, with parameters representing timing and intensity of the growth spurt, were used to describe growth, separately by sex. Associations between region, ART regimen, age, height-for-age (HAZ), and BMI-for-age z-scores (BMIz) at ART initiation (baseline) and age 10 years, and SITAR parameters were explored. Four thousand seven hundred and twenty-three ALWPHIV were included: 51% from East and Southern Africa (excluding Botswana and South Africa), 17% Botswana and South Africa, 6% West and Central Africa, 11% Europe and North America, 11% Asia-Pacific, and 4% Central, South America, and Caribbean. Growth spurts were later and least intense in sub-Saharan regions. In females, older baseline age and lower BMIz at baseline were associated with later and more intense growth spurts; lower HAZ was associated with later growth spurts. In males, older baseline age and lower HAZ were associated with later and less intense growth spurts; however, associations between baseline HAZ and timing varied by age. Lower HAZ and BMIz at 10 years were associated with later and less intense growth spurts in both sexes. ALWPHIV who started ART at older ages or already stunted were more likely to have delayed pubertal growth spurts. Longer-term follow-up is important to understand the impact of delayed growth.