Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis

Issued Date

2022-03-01

Resource Type

Article

eISSN

17582652

DOI

10.1002/jia2.25871

Scopus ID

2-s2.0-85125976723

Pubmed ID

35255197

Journal Title

Journal of the International AIDS Society

Volume

25

Issue

3

Rights Holder(s)

SCOPUS

Bibliographic Citation

Journal of the International AIDS Society Vol.25 No.3 (2022)

Suggested Citation

Jesson J. Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis. Journal of the International AIDS Society Vol.25 No.3 (2022). doi:10.1002/jia2.25871 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86068

Title

Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis

Author(s)

Jesson J.

Author's Affiliation

Groupe d’étude Haïtien sur le Sarcome de Kaposi et les Infections Opportunistes
 Siriraj Hospital
 Lighthouse Trust
 Elizabeth Glaser Pediatric AIDS Foundation
 Vall d'Hebron Institut de Recerca
 Centre de Recherche en Épidémiologie et Santé des Populations
 Institute of Social and Preventive Medicine
 Shupyk National Healthcare University of Ukraine
 Azienda Ospedaliero-Universitaria Meyer
 Centre for Infectious Disease Research in Zambia
 Korle Bu Teaching Hospital
 Moi Teaching and Referral Hospital
 Kenya Medical Research Institute
 Medical University of Warsaw
 INED Institut National d' Études Démographiques
 Hospital General Universitario Gregorio Marañon
 Harvard T.H. Chan School of Public Health
 Universidade Federal de Minas Gerais
 Centre Hospitalier Universitaire Saint Pierre, Brussels
 University of Colorado School of Medicine
 Université Toulouse III - Paul Sabatier
 Organisation Mondiale de la Santé
 The Kirby Institute
 The University of North Carolina at Chapel Hill
 University College London
 Indiana University School of Medicine
 Università degli Studi di Firenze
 Santa Maria Hospital, Lisbon
 Karolinska Universitetssjukhuset
 Erasmus MC Sophia Children's Hospital
 Universidade Federal de São Paulo
 Bronx-Lebanon Hospital Center
 Icahn School of Medicine at Mount Sinai
 Victor Babes National Institute
 Mailman School of Public Health
 UCL Great Ormond Street Institute of Child Health
 Faculty of Health Sciences
 UNAIDS
 Texas Children's Hospital Houston
 UNICEF
 Medecins Sans Frontieres
 Rutgers New Jersey Medical School
 Faculty of Medicine and Health Sciences
 Tulane University Health Sciences Center
 Albert Einstein College of Medicine of Yeshiva University
 Chiang Mai University
 Università degli Studi di Padova
 University of Cape Town
 Baylor College of Medicine Children's Foundation
 Republican Clinical Hospital of Infectious Diseases
 University Hospital (CHU) of Yopougon
 Morogoro Regional Hospital
 SolidarMed
 Baylor College of Medicine Children's Foundation-Tanzania
 Centre National Hospitalier Universitaire Hubert Koutoukou Maga
 Baylor College of Medicine Children's Foundation
 Centro Hospitalar do Porto
 Baylor College of Medicine Children's Foundation Malawi
 Baylor College of Medicine Children's Foundation-Lesotho
 Baylor College of Medicine Children's Foundation-Swaziland
 TREAT Asia/amfAR - The Foundation for AIDS Research
 CHU Gabriel-Touré
 Pediatric Hospital Kalembe Lembe
 Children's Hospital of Eastern Switzerland

Other Contributor(s)

Mahidol University

Abstract

Introduction: Adolescents living with HIV are subject to multiple co-morbidities, including growth retardation and immunodeficiency. We describe growth and CD4 evolution during adolescence using data from the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) global project. Methods: Data were collected between 1994 and 2015 from 11 CIPHER networks worldwide. Adolescents with perinatally acquired HIV infection (APH) who initiated antiretroviral therapy (ART) before age 10 years, with at least one height or CD4 count measurement while aged 10–17 years, were included. Growth was measured using height-for-age Z-scores (HAZ, stunting if <-2 SD, WHO growth charts). Linear mixed-effects models were used to study the evolution of each outcome between ages 10 and 17. For growth, sex-specific models with fractional polynomials were used to model non-linear relationships for age at ART initiation, HAZ at age 10 and time, defined as current age from 10 to 17 years of age. Results: A total of 20,939 and 19,557 APH were included for the growth and CD4 analyses, respectively. Half were females, two-thirds lived in East and Southern Africa, and median age at ART initiation ranged from <3 years in North America and Europe to >7 years in sub-Saharan African regions. At age 10, stunting ranged from 6% in North America and Europe to 39% in the Asia-Pacific; 19% overall had CD4 counts <500 cells/mm3. Across adolescence, higher HAZ was observed in females and among those in high-income countries. APH with stunting at age 10 and those with late ART initiation (after age 5) had the largest HAZ gains during adolescence, but these gains were insufficient to catch-up with non-stunted, early ART-treated adolescents. From age 10 to 16 years, mean CD4 counts declined from 768 to 607 cells/mm3. This decline was observed across all regions, in males and females. Conclusions: Growth patterns during adolescence differed substantially by sex and region, while CD4 patterns were similar, with an observed CD4 decline that needs further investigation. Early diagnosis and timely initiation of treatment in early childhood to prevent growth retardation and immunodeficiency are critical to improving APH growth and CD4 outcomes by the time they reach adulthood.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/86068

Collections

Scopus 2022