Growth Patterns of HIV Infected Indian Children in Response to ART: A Clinic Based Cohort Study.
Growth Patterns of HIV Infected Indian Children in Response to ART: A Clinic Based Cohort Study.
复制标题
HIV 感染的印度儿童对 ART 的生长模式：基于临床的队列研究。
DOI：
10.1007/s12098-014-1659-1
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发表时间：
2015
影响因子：
4.3
通讯作者：
Emmanuel,PatriciaJ
中科院分区：
文献类型：
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作者：
Parchure,RituS;Kulkarni,VinayV;Darak,TruptiS;Mhaskar,Rahul;Miladinovic,Branko;Emmanuel,PatriciaJ
目的描述在印度一家私人诊所接受人类免疫缺陷病毒（CLHIV）感染的儿童开始抗逆转录病毒治疗（ART）后的追赶生长情况。方法回顾性分析在印度浦那Prayas诊所就诊的CLHIV患者资料。身高和体重z分数（HAZ， WAZ）采用WHO生长图计算。在基线和至少一个后续随访HAZ/WAZ可用的情况下，使用混合方法模型评估抗逆转录病毒治疗后的追赶生长。采用STATA 12进行统计分析。结果1998 - 2011年共纳入466名儿童，其中女孩201名，男孩265名，中位年龄为7岁。总共有302名儿童开始接受抗逆转录病毒治疗；其中73名儿童和76名儿童分别被纳入WAZ和HAZ的追赶生长分析。接受ART治疗后，WAZ和HAZ的中位数分别从- 2.14增加到- 1.34 （p= 0.007）和- 2.42增加到- 1.94 （p= 0.34）。使用混合模型（调整性别、监护、基线年龄、基线WAZ/HAZ、基线和随时间变化的WHO临床分期）的多变量分析显示，WAZ （coef = 0.2, 95% CI: - 0.06至0.46）和HAZ （coef = 0.49, 95% CI: 0.21至0.77）随抗逆转录病毒治疗时间的延长而增加。基线WAZ/HAZ较低和年龄较大与追赶性生长受损有关。住院儿童和基线临床阶段较晚期的儿童在WAZ方面表现出较高的增长。结论抗逆转录病毒治疗开始时发育迟缓和体重不足的发生率较高。抗逆转录病毒治疗取得了持续的赶超增长。该研究强调了早期抗逆转录病毒治疗在实现CLHIV正常生长方面的益处。
ObjectiveTo describe catch-up growth after antiretroviral therapy (ART) initiation among children living with human immunodeficiency virus (CLHIV), attending a private clinic in India.MethodsThis is a retrospective analysis of data of CLHIV attending Prayas clinic, Pune, India. Height and weight z scores (HAZ, WAZ) were calculated using WHO growth charts. Catch-up growth post-ART was assessed using a mixed method model in cases where baseline and at least one subsequent follow-up HAZ/WAZ were available. STATA 12 was used for statistical analysis.ResultsDuring 1998 to 2011, 466 children were enrolled (201 girls and 265 boys; median age = 7 y). A total of 302 children were ever started on ART; of which 73 and 76 children were included for analysis for catch up growth in WAZ and HAZ respectively. Median WAZ and HAZ increased from −2.14 to −1.34 (p= 0.007) and −2.42 to −1.94 (p= 0.34), respectively, 3 y post ART. Multivariable analysis using mixed model (adjusted for gender, guardianship, baseline age, baseline WAZ/HAZ, baseline and time varying WHO clinical stage) showed gains in WAZ (coef = 0.2, 95 % CI: −0.06 to 0.46) and HAZ (coef = 0.49, 95 % CI: 0.21 to 0.77) with time on ART. Lower baseline WAZ/HAZ and older age were associated with impaired catch-up growth. Children staying in institutions and with baseline advanced clinical stage showed higher gain in WAZ.ConclusionsThe prevalence of stunting and underweight was high at ART initiation. Sustained catch-up growth was seen with ART. The study highlights the benefit of early ART in achieving normal growth in CLHIV.