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Risk Factors for Growth Retardation in HIV-infected Senegalese Children on Antiretroviral Treatment: The ANRS 12279 MAGGSEN Pediatric Cohort Study

Cames, Cecile PhD; Pascal, Lea MSc; Diack, Aminata MD; Mbodj, Helene MD; Ouattara, Baly MD; Diagne, Ndeye Rama PhD, MD; Diallo, Ndeye Fatou MD; Msellati, Philippe PhD, MD; Mbaye, Ngagne MD; Sy Signate, Haby PhD, MD; on behalf of MAGGSEN Cohort Study Group

Pediatric Infectious Disease Journal: April 2017 - Volume 36 - Issue 4 - p e87–e92
doi: 10.1097/INF.0000000000001454
HIV Reports

Objectives: To describe prevalence and risk factors for wasting and stunting among HIV-infected children with a median duration of 3 years of antiretroviral therapy (ART) at the time of their enrollment in the cohort study.

Methods: Wasting and stunting at ART initiation and enrollment were defined as weight-for-height/body mass index-for-age Z scores < −2 and height-for-age Z scores < −2, respectively. Logistic regression was used to assess risk factors for wasting and stunting. Main predictive factors were age at enrollment, nutritional status and age (< or ≥5 years) at ART initiation and ART duration (< or ≥3 years on first-line, or ≥3 years including a switch to second-line ART).

Results: Two hundred forty-four children 2–16 years of age were enrolled. Overall, wasting and stunting prevalence dropped off consistently in children 2–10 years of age, between ART initiation and enrollment, while it remained at high levels, 52% and 42%, respectively, in children 10–16 years of age. Risk factors for wasting at enrollment were ART duration of ≥3 years including a switch to second-line [adjusted odds ratio (aOR): 3.9, 95% confidence interval (CI): 1.7–8.9] and wasting at ART initiation (aOR: 2.7, 95% CI: 1.4–5.2). The risk factor for stunting at enrollment was stunting at ART initiation (aOR: 11.6, 95% CI: 5.4–25.0), independent of ART duration.

Conclusions: Malnutrition at the time of ART initiation was the main predictor of malnutrition at enrollment among HIV-infected children on ART. Longer duration on ART had no overall protective effect on wasting and stunting. Growth and virologic monitoring are of utmost importance in the comprehensive care of children with HIV infection.

From the *Institut de Recherche pour le Développement (IRD), UMI233 IRD, INSERM U1175, Université de Montpellier, Montpellier, France; Centre Hospitalier National d’Enfants Albert Royer, Dakar, Senegal; and Synergie Pour l’Enfance, Centre Hospitalier Roi Baudouin, Guediawaye, Senegal.

Accepted for publication June 5, 2016.

The MAGGSEN Cohort Study Group members are listed in the Appendix.

Financial support to the MAGGSEN Cohort (No.12279) was provided by the Agence Nationale de Recherche sur le SIDA et les hépatites virales (ANRS). The authors have no conflicts of interest to disclose.

Address for correspondence: Cecile Cames, PhD, UMI233 IRD, U1175 INSERM, 911 av Agropolis, 34394, BP 64501, Montpellier, France. E-mail: cecile.cames@ird.fr.

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