Objectives: Previous studies have described impaired growth in HIV-infected children. Many of them showed weight and height improve after ART initiation Most series include children from resource limited settings in which malnutrition is frequent and treatment is not fully available. We aim to characterize long-term growth in a cohort of HIV-infected children after ART initiation and to identify determinant factors.
Methods: HIV-infected children born between January 2000 and December 2017 participating in the Spanish Cohort of HIV-infected Children (CoRISpe) with available anthropometric data were included. Clinical and immunovirological variables and anthropometrics were collected yearly during the study period.
Results: A total of 124 childrens were included, 60.5% female, all vertically HIV-infected and on treatment, 34% born abroad. A 55% of cases were diagnosed immediately after birth, and 53% achieved viral suppression within one year of treatment. Median CD4 cell counts at diagnosis: 1400 cell/mL [400-1800]. Seven patients (5%) were late diagnosis (<200 CD4). At baseline, median Z-score for weight, height and BMI were -1,19 [-1.7 to -0.29], -1.1 [-1.93 to -0.03], and -0,72 [-1.31 to -0.04] respectively. We observed an increase in weight gain and linear growth rate after one year (median z -score for weight, height and BMI: - 0.65 [-1.13 to 0.02], - 0.36 [- 1.46 to 0.20] and - 0.67 [-1.07 to 0.42]. No differences were found at other followings time points. Viremic patients and those diagnosed late or at an older age showed a tendency towards delayed growth but no significance could be found.
Conclusion: In our study in an European cohort, prompt ART initiation improved growth status of HIV-infected children. The effect of the immunological status seems to impact growth in early stages of life. Larger studies are warranted to evaluate the role of treatment / viral suppression on long- term growth in children.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology