Effect of baseline immunological condition, virological response and duration of HAART on growth in HIV-infected adolescents. Lazarus E 1 ; Otwombe K 1 ; Mohapi L 1 ; Cescon A 2,3 ; Violari A 1 ; Laher F 1 Institutions: 1 Perinatal HIV Research Unit, Soweto, South Africa, 2 Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada, 3 British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada, 1
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Lazarus E 1 ; Otwombe K 1 ; Mohapi L 1 ; Cescon A 2,3 ; Violari A 1 ; Laher F 1
Effect of baseline immunological condition, virological response and duration of HAART on growth in HIV-infected adolescents. Lazarus E 1 ; Otwombe K 1 ; Mohapi L 1 ; Cescon A 2,3 ; Violari A 1 ; Laher F 1 - PowerPoint PPT Presentation
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Effect of baseline immunological condition, virological response and
duration of HAART on growth in HIV-infected adolescents.
Institutions: 1Perinatal HIV Research Unit, Soweto, South Africa, 2Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada, 3British Columbia Centre for Excellence in
HIV/AIDS, Vancouver, Canada, 1
Effect of HIV on child & adolescent growth from the literature
• HIV is associated with poor growth in children1-3 • Stunting (short-for-age) is the most common
abnormal growth pattern4
• Height-for-age is more closely linked to disease progression than weight-for age5
• Survival related to height growth velocity6
1Gertner JM , J Pediatr 1994; 2Moye J Jr, J Pediatr 1996; 3Carey VJ, AIDS 1998; 4Arpadi, JAIDS 2000; 5Benjamin DK, AIDS 2003; 6Chantry CJ, Pediatr Infect Dis J, 2003
Background Methods Results Conclusions
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Effect of HAART on child & adolescent growthfrom the literature
• HAART improves weight and height1-8
• Improved growth may be associated with –Virological response1,5 – Immunological response3,6
– Immunological stage at initiation of ART8
–Age at start of HAART3,7,8
1Guillén S, Pediatr Infect Dis J 2007; 2Kabue MM, AIDS Patient CARE STDS 2008; 3 Nachman SA, Pediatr Infect Dis J 2005; 4Song R, Pediatrics 2007; 5Verweel G, Pediatrics 2002; 6Ghaffari G, Pediatrics 2004; 7Bakeera-Kitaka S, J Pediatr Infect Dis, 2008; 8Kekitiinwa A, JAIDS,2008
Background Methods Results Conclusions
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Aim
• To determine the correlation with adolescent growth of: – baseline CD4 – age at initiation of HAART – virological response– treatment duration
Background Methods Results Conclusions
4
Setting
• Retrospective, cross-sectional analysis • Perinatal HIV Research Unit, Soweto, S Africa• HAART-recipients aged 11-19 years
Background Methods Results Conclusions
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How is growth measured?
• Wt & ht plotted on centile chart• Z-score calculated using SAS
software provided by the CDC• Z-score: measure of standard
deviations from mean • 50th centile z-score = 0• Example
– 13 year old female– Wt = 35kg WAZ = -
2.48– Ht = 140 cm HAZ = -1.57
Background Methods Results Conclusions
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What is growth?
• Difference between gender adjusted growth measurements between most recent clinic visit and baseline:– Weight for age z-score (WAZ)– Height for age z –score (HAZ)
Background Methods Results Conclusions
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Statistical analysis
• Chi-square contingency table analysis: association between growth and – duration of treatment– baseline CD4– age at baseline – most recent viral load.
• Where an association existed, a univariate analysis was performed to determine the predictor of growth.