The Indian Journal of Pediatrics

, Volume 82, Issue 6, pp 519–524

Growth Patterns of HIV Infected Indian Children in Response to ART: A Clinic Based Cohort Study

  • Ritu S. Parchure
  • Vinay V. Kulkarni
  • Trupti S. Darak
  • Rahul Mhaskar
  • Branko Miladinovic
  • Patricia J. Emmanuel
Original Article

DOI: 10.1007/s12098-014-1659-1

Cite this article as:
Parchure, R.S., Kulkarni, V.V., Darak, T.S. et al. Indian J Pediatr (2015) 82: 519. doi:10.1007/s12098-014-1659-1

Abstract

Objective

To describe catch-up growth after antiretroviral therapy (ART) initiation among children living with human immunodeficiency virus (CLHIV), attending a private clinic in India.

Methods

This is a retrospective analysis of data of CLHIV attending Prayas clinic, Pune, India. Height and weight z scores (HAZ, WAZ) were calculated using WHO growth charts. Catch-up growth post-ART was assessed using a mixed method model in cases where baseline and at least one subsequent follow-up HAZ/WAZ were available. STATA 12 was used for statistical analysis.

Results

During 1998 to 2011, 466 children were enrolled (201 girls and 265 boys; median age = 7 y). A total of 302 children were ever started on ART; of which 73 and 76 children were included for analysis for catch up growth in WAZ and HAZ respectively. Median WAZ and HAZ increased from −2.14 to −1.34 (p = 0.007) and −2.42 to −1.94 (p = 0.34), respectively, 3 y post ART. Multivariable analysis using mixed model (adjusted for gender, guardianship, baseline age, baseline WAZ/HAZ, baseline and time varying WHO clinical stage) showed gains in WAZ (coef = 0.2, 95 % CI: −0.06 to 0.46) and HAZ (coef = 0.49, 95 % CI: 0.21 to 0.77) with time on ART. Lower baseline WAZ/HAZ and older age were associated with impaired catch-up growth. Children staying in institutions and with baseline advanced clinical stage showed higher gain in WAZ.

Conclusions

The prevalence of stunting and underweight was high at ART initiation. Sustained catch-up growth was seen with ART. The study highlights the benefit of early ART in achieving normal growth in CLHIV.

Keywords

HIV/AIDS HIV infected children Anti-retroviral therapy Catch up growth Growth failure 

Copyright information

© Dr. K C Chaudhuri Foundation 2015

Authors and Affiliations

  • Ritu S. Parchure
    • 1
  • Vinay V. Kulkarni
    • 1
  • Trupti S. Darak
    • 1
  • Rahul Mhaskar
    • 2
  • Branko Miladinovic
    • 2
  • Patricia J. Emmanuel
    • 3
  1. 1.PrayasPuneIndia
  2. 2.Center for Evidence Based Medicine and Health Outcomes ResearchUniversity of South FloridaTampaUSA
  3. 3.Department of Pediatrics, College of MedicineUniversity of South FloridaTampaUSA