Journal
AIDS
Volume 33, Issue 12, Pages 1897-1910Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0000000000002294
Keywords
Europe; growth; height; HIV; perinatal; puberty; Thailand
Categories
Funding
- Fundacion para la Investigacion y Prevencion de SIDA en Espana (FIPSE) [FIPSE 3608229/09, FIPSE 240800/09, FIPSE 361910/10]
- Red Tematica de Investigacion en SIDA (RED RIS) - Instituto de Salud Carlos III (ISCIII) as part of the Plan R+D+I [RD12/0017/0035, RD12/0017/0037]
- ISCIII-Subdireccion General de Evaluacion
- Fondo Europeo de Desarrollo Regional (FEDER)
- PENTA Foundation
- Medical Research Council [MC_UU_12023/26]
- Mutua Madrilena [2012/0077]
- Gilead Fellowship [2013/0071]
- FIS [PI15/00694]
- CoRISpe [RED RIS RD06/0006/0035, RD06/0006/0021]
- MRC [MC_UU_12023/26, MC_UU_12023/17] Funding Source: UKRI
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Objective: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. Design: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. Methods: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. Results: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. Conclusion: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age.
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