Title: Growth in virologically suppressed HIV positive children on antiretroviral therapy: individual and population-level references
Authors: Keiser, Olivia ×
Blaser, Nello
Davies, Mary-Ann
Wessa, Patrick
Eley, Brian
Moultrie, Harry
Rabie, Helena
Technau, Karl
Ndirangu, James
Garone, Daniela
Giddy, Janet
Grimwood, Ashraf
Gsponer, Thomas
Egger, Matthias #
Issue Date: 2015
Publisher: Williams & Wilkins
Series Title: The Pediatric Infectious Disease Journal vol:34 issue:10 pages:e254-e259
Abstract: Background
Combination antiretroviral therapy (ART) suppresses viral replication in HIV-infected
children. The growth of virologically suppressed children on ART has not been well
documented. We aimed to develop dynamic reference curves for weight-for-age z
scores (WAZ) and height-for-age z scores (HAZ).

Children aged <11 years at ART initiation with continuously undetectable viral loads
(<400 copies/ml) treated at seven South African ART programs with routine viral load
monitoring were included. We used multilevel models to define trajectories of WAZ and
HAZ up to 3 years and developed a web application to monitor trajectories in individual

A total of 4,876 children were followed for 7,407 person-years. Analyses were stratified
by baseline z-scores and age, which were the most important predictors of growth
response. The youngest children showed the most pronounced increase in weight and
height initially but catch-up growth stagnated after 1-2 years. Three years after starting
ART, WAZ ranged from -2.2 (95% Prediction interval -5.6 to 0.8) in children with
baseline age >5 years and z-score <-3 to 0.0 (-2.7 to 2.4) in children with baseline age
<2 years and WAZ >-1. For HAZ the corresponding range was -2.3 (-4.9 to 0.3) in
children with baseline age>5 years and z-score <-3 to 0.3 (-3.1 to 3.4) in children with
baseline age 2-5 years and HAZ >-1.

We have developed an online tool to calculate reference trajectories in fully
suppressed children. The web application could help to define 'optimal' growth
response and identify children with treatment failure.
ISSN: 0891-3668
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Department of Marketing Management, Campus Carolus Antwerp
Faculty of Economics and Business (FEB) - miscellaneous
× corresponding author
# (joint) last author

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