Age and HIV stage at initiation of highly active antiretroviral therapy determine non-reversal of stunting at 3 years of treatment
Journal Title: Paediatrica Indonesiana - Year 2018, Vol 58, Issue 4
Abstract
Background Highly active antiretroviral therapy (HAART) has been reported to improve growth, especially in the first 2 years of treatment. It is not clear whether catch up growth is maintained after 2 years of HAART. Objective To assess growth in stunted children with HIV after 3 years of HAART and analyze possible risk factors for non-reversal of stunting. Methods This study was done from May 2016 to April 2017 to follow children with HIV who started HAART between January 2009 and April 2014, and continued for 3 years. Inclusion criteria were children with HIV, aged < 18 years, compliance to the regimen, and stunting. Exclusion criteria were patients lost to follow up or who died prior to 3 years of HAART. Non-reversal of stunting was defined as HAZ ≤ -2SD after 3 years of HAART. Possible risk factors for non-reversal were analyzed using Chi-square test with P<0.05, as well as risk ratio (RR) and 95% confidence intervals (CI). Results Of 150 HIV-infected pediatric patients, 115 were on HAART and 55 (47.8%) were stunted at HAART initiation. Of the 55 stunted and HAART-treated children, 31 (56.4%) were male. Baseline median age was 3.6 years (interquartile range 0.37-8.48). Non-reversal occurred in 32 (58.2%) subjects. Multivariate Cox regression model analysis showed predictors of non-reversal after 3 years of HAART to be age >2 years (RR 16.05; 95%CI 2.89 to 89.02; P=0.002) and HIV stage III-IV (RR 8.93; 95%CI 1.47 to 54.37; P=0.017). Conclusion HAART initiation at age >2 years and HIV clinical stage III-IV at diagnosis are risk factors for non-reversal of stunting after 3 years of HAART.
Authors and Affiliations
Putu Vedaswari, Ketut Wati, I Gusti Sidiartha, Hendra Santoso, Komang Witarini
Keywords
Related Articles
- EP ID EP508833
- DOI 10.14238/pi58.4.2018.180-5
- Views 41
- Downloads 0
Irrational use of antibiotics and clinical outcomes in children with pneumonia
Background Pneumonia is a major cause of morbidity and mortality in children under five. Antibiotic treatment must be started immediately in children with pneumonia. The irrational use of antibiotics may increase morbidi...
Does malnutrition influence outcome in children undergoing congenital heart surgery in a developing country?
Background Most children undergoing cardiac surgery forcongenital heart disease (CHD) in developing countries aremalnourished. Malnutrition is known as a co-morbidity factorthat might predict and influence outcomes after...
Tumor necrosis factor-alpha and interleukin-6 in early-onset neonatal sepsis
Background Neonatal sepsis remains a major cause of mortality and morbidity in newborns. Early-onset neonatal sepsis occurs in infants under the age of 72 hours, while late-onset neonatal sepsis occurs in infants over th...
Reticulocyte hemoglobin equivalent for diagnosing iron deficiency anemia in children
Background The prevalence of iron deficiency anemia (IDA) remains high in Indonesian children. When anemia is detected in a patient, the physician’s task is to identify the cause, address it, provide iron therapy, and pr...
Physical activity assessments in obese and non-obese adolescents using the Bouchard diary
Background Obesity is now a global epidemic problem. Increasedprevalence of obesity is associated with increased sedentarybeh avior and low physical activity.Objective To assess the physical activity patterns of adolesce...