Details

Autor(en) / Beteiligte

• Jesson, Julie
• Dahourou, Désiré L.
• Amorissani Folquet, Madeleine
• Malateste, Karen
• Yonaba, Caroline
• N’Gbeche, Marie-Sylvie
• Ouédraogo, Sylvie
• Mea-Assande, Véronique
• Amani-Bossé, Clarisse
• Blanche, Stéphane
• Timité-Konan, Marguerite
• Leroy, Valériane

Titel

Malnutrition, Growth Response and Metabolic Changes Within the First 24 Months After ART Initiation in HIV-infected Children Treated Before the Age of 2 Years in West Africa

Ist Teil von

• The Pediatric infectious disease journal, 2018-08, Vol.37 (8), p.781-787

Erscheinungsjahr

2018

Beschreibungen/Notizen

• Background: There is limited information about malnutrition, growth evolution and metabolic changes among children initiated early on lopinavir-based antiretroviral therapy (ART) in Africa. Methods: HIV-1-infected children, age <2 years were initiated on ART, as part of the MONOD ANRS 12206 project, conducted in Burkina Faso and Côte d’Ivoire. Weight-for-age, height-for-age and weight-for-height Z scores defined malnutrition [Z score less than −2 standard deviations (SDs)] using World Health Organization growth references. Biologic data were collected every 6 months. Factors associated with baseline malnutrition were evaluated using multivariate logistic regression, and with growth evolution in the first 24 months on ART using linear mixed models. Results: Between 2011 and 2013, 161 children were enrolled: 64% were from Abidjan, 54% were girls. At ART initiation, median age was 13.7 months (interquartile range 7.7; 18.4), 52% were underweight (weight-for-age), 52% were stunted (height-for-age) and 36% were wasted (weight-for-height). Overall, baseline malnutrition was more likely for children living in Burkina Faso, with low birth weight, never breastfed and older age (12–24 months). Growth improved on ART, mainly within the first 6 months for weight, and was greater for the most severely malnourished children at baseline, but 8%–32% remained malnourished after 24 months. Over the 24-month period of ART, there was a significant increase of hypercholesterolemia and decrease of anemia and hypoalbuminemia. Conclusions: Prevalence of malnutrition was high before ART initiation. Even though growth improved on ART, some children remained malnourished even after 2 years of ART, highlighting the need for more active nutritional support.