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Weight as Predictors of Clinical Progression and Treatment Failure: Results From the TREAT Asia Pediatric HIV Observational Database

Kariminia, Azar PhD*; Durier, Nicolas MD, MPH; Jourdain, Gonzague MD, PhD; Saghayam, Suneeta MSc, PhD§; Do, Chau V. MD; Nguyen, Lam Van MD; Hansudewechakul, Rawiwan MD#; Lumbiganon, Pagakrong MD**; Chokephaibulkit, Kulkanya MD††; Truong, Khanh Huu MD‡‡; Sirisanthana, Virat MD§§; Ung, Vibol MD‖‖; Vonthanak, Saphonn MD, PhD¶¶; Ananworanich, Jintanat MD, PhD##; Nik Yusoff, Nik Khairulddin MD***; Kurniati, Nia MD†††; Azahar Razali, Kamarul MD‡‡‡; Fong, Moy Siew MBBS§§§; Nallusamy, Revathy MBBS‖‖‖; Wati, Dewi Kumara MD¶¶¶

JAIDS Journal of Acquired Immune Deficiency Syndromes: September 1st, 2014 - Volume 67 - Issue 1 - p 71–76
doi: 10.1097/QAI.0000000000000227
Brief Report: Clinical Science

Objective: To evaluate the value of time-updated weight and height in predicting clinical progression, and immunological and virological failure in children receiving combination antiretroviral therapy (cART).

Methods: We used Cox regression to analyze data of a cohort of Asian children.

Results: A total of 2608 children were included; median age at cART was 5.7 years. Time-updated weight for age z score < −3 was associated with mortality (P < 0.001) independent of CD4% and < −2 was associated with immunological failure (P ≤ 0.03) independent of age at cART.

Conclusions: Weight monitoring provides useful data to inform clinical management of children on cART in resource-limited settings.

*The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia;

TREAT Asia/amfAR—The Foundation for AIDS Research, Bangkok, Thailand;

Programs for HIV Prevention and Treatment, Institut de Recherche pour le Développement, France, and Chiang Mai University, Chiang Mai, Thailand;

§YR Gaitonde Centre for AIDS Research and Education, Chennai, India;

Infectious Disease Department, Children's Hospital 2, Ho Chi Minh City, Vietnam;

Infectious Disease Department, National Hospital of Pediatrics, Hanoi, Vietnam;

#Pediatric Department, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand;

**Pediatric Department , Khon Kaen University, Khon Kaen, Thailand;

††Pediatric Department , Siriraj Hospital, Mahidol University, Bangkok, Thailand;

‡‡Infectious Disease Department, Children's Hospital 1, Ho Chi Minh City, Vietnam;

§§Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand;

‖‖TB/HIV Department, National Pediatric Hospital, Phnom Penh, Cambodia;

¶¶Research Unit, National Centre for HIV/AIDS, Dermatology and STDs, Phnom Penh, Cambodia;

##HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand;

***Department of Pediatrics, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia;

†††Pediatric Allergy-Immunology Division, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia;

‡‡‡Pediatric Institute, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia;

§§§Department of Pediatrics, Hospital Likas, Kota Kinabalu, Malaysia;

‖‖‖Department of Pediatrics, Penang Hospital, Penang, Malaysia; and

¶¶¶Allergy-Immunology Division, Sanglah Hospital, Udayana University, Bali, Indonesia.

Correspondence to: Azar Kariminia, PhD, Biostatistics and Database Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Cliffbrook Campus, Building CC4, 45 Beach Street, Coogee NSW 2034, Australia (e-mail: akariminia@kirby.unsw.edu.au).

The TREAT Asia Pediatric HIV Observational Database is an initiative of TREAT Asia, a program of amfAR, The Foundation for AIDS Research, with support from the US National Institutes of Health's National Institute of Allergy and Infectious Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and National Cancer Institute as part of the International Epidemiologic Databases to Evaluate AIDS (IeDEA; U01AI069907), and the AIDS Life Association. The Kirby Institute is funded by the Australian Government Department of Health and Ageing and is affiliated with the Faculty of Medicine, The University of New South Wales.

The authors have no conflicts of interest to disclose.

Conceptualize and design the study, analyses, and initial manuscript drafting: A.K. Study design, interpretation of the data, and review and revise the manuscript: N.D., G.J., and D.K.W. Coordinated and supervised data collection at 18 sites, and critically reviewed the manuscript: S.S., C.V.D., V.L.N., R.H., P.L., K.C., H.K.T., V.S., V.U., S.V., J.A., S.M.F. and R.N. All authors approved the final manuscript as submitted.

Received December 10, 2013

Accepted April 25, 2014

© 2014 by Lippincott Williams & Wilkins