Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Mar 1:11:54.
doi: 10.1186/1471-2334-11-54.

Weight and height z-scores improve after initiating ART among HIV-infected children in rural Zambia: a cohort study

Catherine G Sutcliffe  1 , Janneke H van Dijk, Bornface Munsanje, Francis Hamangaba, Pamela Sinywimaanzi, Philip E Thuma, William J Moss
Affiliations

Weight and height z-scores improve after initiating ART among HIV-infected children in rural Zambia: a cohort study

Catherine G Sutcliffe et al. BMC Infect Dis. .

Abstract

Background: Deficits in growth observed in HIV-infected children in resource-poor settings can be reversed with antiretroviral treatment (ART). However, many of the studies have been conducted in urban areas with older pediatric populations. This study was undertaken to evaluate growth patterns after ART initiation in a young pediatric population in rural Zambia with a high prevalence of undernutrition.

Methods: Between 2007 and 2009, 193 HIV-infected children were enrolled in a cohort study in Macha, Zambia. Children were evaluated every 3 months, at which time a questionnaire was administered, height and weight were measured, and blood specimens were collected. Weight- and height-for-age z-scores were constructed from WHO growth standards. All children receiving ART at enrollment or initiating ART during the study were included in this analysis. Linear mixed effects models were used to model trajectories of weight and height-for-age z-scores.

Results: A high proportion of study children were underweight (59%) and stunted (72%) at treatment initiation. Improvements in both weight- and height-for-age z-scores were observed, with weight-for-age z-scores increasing during the first 6 months of treatment and then stabilizing, and height-for-age z-scores increasing consistently over time. Trajectories of weight-for-age z-scores differed by underweight status at treatment initiation, with children who were underweight experiencing greater increases in z-scores in the first 6 months of treatment. Trajectories of height-for-age z-scores differed by age, with children older than 5 years of age experiencing smaller increases over time.

Conclusions: Some of the effects of HIV on growth were reversed with ART initiation, although a high proportion of children remained underweight and stunted after two years of treatment. Partnerships between treatment and nutrition programs should be explored so that HIV-infected children can receive optimal nutritional support.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mean (95% CI) weight-for-age (A) and height-for-age (B) z-scores by time since ART initiation. *sample sizes are smaller due to missing data at ART initiation
See this image and copyright information in PMC

References

    1. Lepage P, Msellati P, Hitimana DG, Bazubagira A, Van Goethem C, Simonon A, Karita E, Dequae-Merchadou L, Van de Perre P, Dabis F. Growth of human immunodeficiency type 1-infected and uninfected children: a prospective cohort study in Kigali, Rwanda, 1988 to 1993. The Pediatric infectious disease journal. 1996;15(6):479–485. doi: 10.1097/00006454-199606000-00003. - DOI - PubMed
    1. Sutcliffe CG, Scott S, Mugala N, Ndhlovu Z, Monze M, Quinn TC, Cousens S, Griffin DE, Moss WJ. Survival from 9 months of age among HIV-infected and uninfected Zambian children prior to the availability of antiretroviral therapy. Clin Infect Dis. 2008;47(6):837–844. doi: 10.1086/591203. - DOI - PMC - PubMed
    1. Henderson RA, Miotti PG, Saavedra JM, Dallabetta G, Chiphangwi J, Liomba G, Taha TE, Yolken RH. Longitudinal growth during the first 2 years of life in children born to HIV-infected mothers in Malawi, Africa. Pediatric AIDS and HIV infection. 1996;7(2):91–97. - PubMed
    1. Bailey RC, Kamenga MC, Nsuami MJ, Nieburg P, St Louis ME. Growth of children according to maternal and child HIV, immunological and disease characteristics: a prospective cohort study in Kinshasa, Democratic Republic of Congo. International journal of epidemiology. 1999;28(3):532–540. doi: 10.1093/ije/28.3.532. - DOI - PubMed
    1. WHO. Antiretroviral therapy for HIV infection in infants and children: Towards universal access, Recommendations for a public health approach, 2010 revision. Geneva, Switzerland: World Health Organization; 2010. - PubMed

Publication types

Substances