Antiretroviral Therapy in Severely Malnourished, HIV-infected Children in Asia

The Pediatric Infectious Disease Journal
David C BoettigerTREAT Asia Pediatric HIV Observational Database

Abstract

Information on antiretroviral therapy (ART) use in HIV-infected children with severe malnutrition (SM) is lacking. We investigated long-term ART outcomes in this population. Children enrolled in the TREAT Asia Pediatric HIV Observational Database who had SM (weight-for-height or body mass index-for-age Z score less than -3) at ART initiation were analyzed. Generalized estimating equations were used to investigate poor weight recovery (weight-for-age Z score less than -3) and poor CD4% recovery (CD4% <25), and competing risk regression was used to analyze mortality and toxicity-associated treatment modification. Three hundred fifty-five (11.9%) of 2993 children starting ART had SM. Their median weight-for-age Z score increased from -5.6 at ART initiation to -2.3 after 36 months. Not using trimethoprim-sulfamethoxazole prophylaxis at baseline was associated with poor weight recovery [odds ratio: 2.49 vs. using; 95% confidence interval (CI): 1.66-3.74; P < 0.001]. Median CD4% increased from 3.0 at ART initiation to 27.2 after 36 months, and 56 (15.3%) children died during follow-up. More profound SM was associated with poor CD4% recovery (odds ratio: 1.78 for Z score less than -4.5 vs. -3.5 to less than -3.0; 95% CI: 1.08-2.92; P ...Continue Reading

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Citations

Jul 30, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·David C BoettigerUNKNOWN Therapeutics Research, Education, and AIDS Training in Asia (TREAT Asia) Pediatric HIV Observational Database
Feb 13, 2018·Current Opinion in HIV and AIDS·Paige L Williams, Julie Jesson
Nov 2, 2019·Tropical Medicine & International Health : TM & IH·David Aguilera-AlonsoPablo Rojo
Aug 20, 2019·BMC Pediatrics·Patrinee TraisathitGonzague Jourdain

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