Early treated HIV-infected children remain at risk of growth retardation during the first five years of life: Results from the ANRS-PEDIACAM cohort in Cameroon.
<h4>Background</h4>Long-term growth in HIV-infected infants treated early in resource-limited settings is poorly documented. Incidence of growth retardation, instantaneous risk of death related to malnutrition and growth parameters evolution during the first five years of life of uninfec...
Main Authors: | , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2019-01-01
|
Series: | PLoS ONE |
Online Access: | https://doi.org/10.1371/journal.pone.0219960 |
id |
doaj-5c22a5582300445487136884994a4351 |
---|---|
record_format |
Article |
spelling |
doaj-5c22a5582300445487136884994a43512021-03-04T10:27:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01147e021996010.1371/journal.pone.0219960Early treated HIV-infected children remain at risk of growth retardation during the first five years of life: Results from the ANRS-PEDIACAM cohort in Cameroon.Casimir Ledoux SofeuMathurin Cyrille TejiokemCalixte Ida PendaCamelia ProtopopescuFrancis Ateba NdongoSuzie Tetang NdiangGeorgette GuemkamJosiane WarszawskiAlbert FayeRoch GiorgiANRS-PEDIACAM study group<h4>Background</h4>Long-term growth in HIV-infected infants treated early in resource-limited settings is poorly documented. Incidence of growth retardation, instantaneous risk of death related to malnutrition and growth parameters evolution during the first five years of life of uninfected and early treated HIV-infected children were compared and associated factors with growth retardation were identified.<h4>Methods</h4>Weight-for-age (WAZ), weight-for-length (WLZ), and length-for-age (LAZ) Z-scores were calculated. The ANRS-PEDIACAM cohort includes four groups of infants with three enrolled during the first week of life: HIV-infected (HI, n = 69), HIV-exposed uninfected (HEU, n = 205) and HIV-unexposed uninfected (HUU, n = 196). The last group included HIV-infected infants diagnosed before 7 months of age (HIL, n = 141). The multi-state Markov model was used to describe the incidence of growth retardation and identified associated factors.<h4>Results</h4>During the first 5 years, 27.5% of children experienced underweight (WAZ<-2), 60.4% stunting (LAZ<-2) and 41.1% wasting (WLZ<-2) at least once. The instantaneous risk of death observed from underweight state (35.3 [14.1-88.2], 84.0 [25.5-276.3], and 6.0 [1.5-24.1] per 1000 person-months for 0-6 months, 6-12 months, and 12-60 months respectively) was higher than from non-underweight state (9.6 [5.7-16.1], 20.1 [10.3-39.4] and 0.3 [0.1-0.9] per 1000 person-months). Compared to HEU, HIL and HI children were most at risk of wasting (adjusted HR (aHR) = 4.3 (95%CI: 1.9-9.8), P<0.001 and aHR = 3.3 (95%CI: 1.4-7.9), P = 0.01 respectively) and stunting for HIL (aHR = 8.4 (95%CI: 2.4-29.7). The risk of underweight was higher in HEU compared to HUU children (aHR = 5.0 (CI: 1.4-10.0), P = 0.001). Others associated factors to growth retardation were chronic pathologies, small size at birth, diarrhea and CD4< 25%.<h4>Conclusions</h4>HIV-infected children remained at high risk of wasting and stunting within the first 5 years period of follow-up. There is a need of identifying suitable nutritional support and best ways to integrate it with cART in pediatric HIV infection global care.https://doi.org/10.1371/journal.pone.0219960 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Casimir Ledoux Sofeu Mathurin Cyrille Tejiokem Calixte Ida Penda Camelia Protopopescu Francis Ateba Ndongo Suzie Tetang Ndiang Georgette Guemkam Josiane Warszawski Albert Faye Roch Giorgi ANRS-PEDIACAM study group |
spellingShingle |
Casimir Ledoux Sofeu Mathurin Cyrille Tejiokem Calixte Ida Penda Camelia Protopopescu Francis Ateba Ndongo Suzie Tetang Ndiang Georgette Guemkam Josiane Warszawski Albert Faye Roch Giorgi ANRS-PEDIACAM study group Early treated HIV-infected children remain at risk of growth retardation during the first five years of life: Results from the ANRS-PEDIACAM cohort in Cameroon. PLoS ONE |
author_facet |
Casimir Ledoux Sofeu Mathurin Cyrille Tejiokem Calixte Ida Penda Camelia Protopopescu Francis Ateba Ndongo Suzie Tetang Ndiang Georgette Guemkam Josiane Warszawski Albert Faye Roch Giorgi ANRS-PEDIACAM study group |
author_sort |
Casimir Ledoux Sofeu |
title |
Early treated HIV-infected children remain at risk of growth retardation during the first five years of life: Results from the ANRS-PEDIACAM cohort in Cameroon. |
title_short |
Early treated HIV-infected children remain at risk of growth retardation during the first five years of life: Results from the ANRS-PEDIACAM cohort in Cameroon. |
title_full |
Early treated HIV-infected children remain at risk of growth retardation during the first five years of life: Results from the ANRS-PEDIACAM cohort in Cameroon. |
title_fullStr |
Early treated HIV-infected children remain at risk of growth retardation during the first five years of life: Results from the ANRS-PEDIACAM cohort in Cameroon. |
title_full_unstemmed |
Early treated HIV-infected children remain at risk of growth retardation during the first five years of life: Results from the ANRS-PEDIACAM cohort in Cameroon. |
title_sort |
early treated hiv-infected children remain at risk of growth retardation during the first five years of life: results from the anrs-pediacam cohort in cameroon. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2019-01-01 |
description |
<h4>Background</h4>Long-term growth in HIV-infected infants treated early in resource-limited settings is poorly documented. Incidence of growth retardation, instantaneous risk of death related to malnutrition and growth parameters evolution during the first five years of life of uninfected and early treated HIV-infected children were compared and associated factors with growth retardation were identified.<h4>Methods</h4>Weight-for-age (WAZ), weight-for-length (WLZ), and length-for-age (LAZ) Z-scores were calculated. The ANRS-PEDIACAM cohort includes four groups of infants with three enrolled during the first week of life: HIV-infected (HI, n = 69), HIV-exposed uninfected (HEU, n = 205) and HIV-unexposed uninfected (HUU, n = 196). The last group included HIV-infected infants diagnosed before 7 months of age (HIL, n = 141). The multi-state Markov model was used to describe the incidence of growth retardation and identified associated factors.<h4>Results</h4>During the first 5 years, 27.5% of children experienced underweight (WAZ<-2), 60.4% stunting (LAZ<-2) and 41.1% wasting (WLZ<-2) at least once. The instantaneous risk of death observed from underweight state (35.3 [14.1-88.2], 84.0 [25.5-276.3], and 6.0 [1.5-24.1] per 1000 person-months for 0-6 months, 6-12 months, and 12-60 months respectively) was higher than from non-underweight state (9.6 [5.7-16.1], 20.1 [10.3-39.4] and 0.3 [0.1-0.9] per 1000 person-months). Compared to HEU, HIL and HI children were most at risk of wasting (adjusted HR (aHR) = 4.3 (95%CI: 1.9-9.8), P<0.001 and aHR = 3.3 (95%CI: 1.4-7.9), P = 0.01 respectively) and stunting for HIL (aHR = 8.4 (95%CI: 2.4-29.7). The risk of underweight was higher in HEU compared to HUU children (aHR = 5.0 (CI: 1.4-10.0), P = 0.001). Others associated factors to growth retardation were chronic pathologies, small size at birth, diarrhea and CD4< 25%.<h4>Conclusions</h4>HIV-infected children remained at high risk of wasting and stunting within the first 5 years period of follow-up. There is a need of identifying suitable nutritional support and best ways to integrate it with cART in pediatric HIV infection global care. |
url |
https://doi.org/10.1371/journal.pone.0219960 |
work_keys_str_mv |
AT casimirledouxsofeu earlytreatedhivinfectedchildrenremainatriskofgrowthretardationduringthefirstfiveyearsofliferesultsfromtheanrspediacamcohortincameroon AT mathurincyrilletejiokem earlytreatedhivinfectedchildrenremainatriskofgrowthretardationduringthefirstfiveyearsofliferesultsfromtheanrspediacamcohortincameroon AT calixteidapenda earlytreatedhivinfectedchildrenremainatriskofgrowthretardationduringthefirstfiveyearsofliferesultsfromtheanrspediacamcohortincameroon AT cameliaprotopopescu earlytreatedhivinfectedchildrenremainatriskofgrowthretardationduringthefirstfiveyearsofliferesultsfromtheanrspediacamcohortincameroon AT francisatebandongo earlytreatedhivinfectedchildrenremainatriskofgrowthretardationduringthefirstfiveyearsofliferesultsfromtheanrspediacamcohortincameroon AT suzietetangndiang earlytreatedhivinfectedchildrenremainatriskofgrowthretardationduringthefirstfiveyearsofliferesultsfromtheanrspediacamcohortincameroon AT georgetteguemkam earlytreatedhivinfectedchildrenremainatriskofgrowthretardationduringthefirstfiveyearsofliferesultsfromtheanrspediacamcohortincameroon AT josianewarszawski earlytreatedhivinfectedchildrenremainatriskofgrowthretardationduringthefirstfiveyearsofliferesultsfromtheanrspediacamcohortincameroon AT albertfaye earlytreatedhivinfectedchildrenremainatriskofgrowthretardationduringthefirstfiveyearsofliferesultsfromtheanrspediacamcohortincameroon AT rochgiorgi earlytreatedhivinfectedchildrenremainatriskofgrowthretardationduringthefirstfiveyearsofliferesultsfromtheanrspediacamcohortincameroon AT anrspediacamstudygroup earlytreatedhivinfectedchildrenremainatriskofgrowthretardationduringthefirstfiveyearsofliferesultsfromtheanrspediacamcohortincameroon |
_version_ |
1714805950102110208 |