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1. Brief Report: AIDS-Defining Events and Deaths in HIV-Infected Children and Adolescents on Antiretrovirals: A 14-Year Study in Thailand.

Author

Traisathit P, Delory T, Ngo-Giang-Huong N, Somsamai R, Techakunakorn P, Theansavettrakul S, Kanjanavanit S, Mekmullica J, Ngampiyaskul C, Na-Rajsima S, Lallemant M, Cressey TR, Jourdain G, Collins IJ, and Le Coeur S

Subjects
Acquired Immunodeficiency Syndrome drug therapy, Acquired Immunodeficiency Syndrome mortality, Adolescent, Antiretroviral Therapy, Highly Active, Child, Child, Preschool, Cohort Studies, Female, HIV Infections drug therapy, HIV Infections mortality, Humans, Infant, Male, Proportional Hazards Models, Thailand epidemiology, Viremia, Acquired Immunodeficiency Syndrome epidemiology, Anti-HIV Agents therapeutic use, HIV Infections epidemiology
Abstract

Background: Data are scarce on the long-term clinical outcomes of perinatally HIV-infected children and adolescents receiving antiretroviral therapy (ART) in low/middle-income countries. We assessed the incidence of mortality before (early) and after (late) 6 months of ART and of the composite outcome of new/recurrent AIDS-defining event or death >6 months after ART start (late AIDS/death) and their associated factors., Methods: Study population was perinatally HIV-infected children (≤18 years) initiating ART within the Program for HIV Prevention and Treatment observational cohort (NCT00433030). Factors associated with late AIDS/death were assessed using competing risk regression models accounting for lost to-follow-up and included baseline and time-updated variables., Results: Among 619 children, "early" mortality incidence was 99 deaths per 1000 person-years of follow-up [95% confidence interval (CI): 69 to 142] and "late" mortality 6 per 1000 person-years of follow-up (95% CI: 4 to 9). Of the 553 children alive >6 months after ART initiation, median age at ART initiation was 6.4 years, CD4% 8.2%, and HIV-RNA load 5.1 log10 copies/mL. Thirty-eight (7%) children developed late AIDS/death after median time of 3.3 years: 24 died and 24 experienced new/recurrent AIDS-defining events (10 subsequently died). Factors independently associated with late AIDS/death were current age ≥13 years (adjusted subdistribution hazard ratio 4.9; 95% CI: 2.4 to 10.1), HIV-RNA load always ≥400 copies/mL (12.3; 95% CI: 4.0 to 37.6), BMI-z-score always <-2 SD (13.7; 95% CI: 3.4 to 55.7), and hemoglobin <8 g/dL at least once (4.6; 95% CI: 2.0 to 10.5)., Conclusions: After the initial 6 months of ART, being an adolescent, persistent viremia, poor nutritional status, and severe anemia were associated with poor clinical outcomes. This supports the need for novel interventions that target children, particularly adolescents with poor growth and uncontrolled viremia.

Published
2018
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2. Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand

Author

Crichton, Siobhan, Belfrage, Eric, Collins, Intira Jeanne, Doerholt, Katja, Judd, Ali, Le Coeur, Sophie, Spoulou, Vana, Goodall, Ruth, Scherpbier, Henriette, Smit, Colette, Goetghebuer, Tessa, Gibb, Diana M., Noguera, Antoni, Luisa Navarro, Maria, Tomas Ramos, Jose, Galli, Luisa, Giaquinto, Carlo, Thorne, Claire, Santa Ansone, Marczynska, Magdalena, Okhonskaia, Liubov, de Tejada, Begona Martinez, Jourdain, Gonzague, Decker, Luc, Ene, Luminita, Hainaut, Marc, Van der Kelen, Evelyne, Delforge, Marc, de Martino, Maurizio, Tovo, Pier Angelo, Patrizia, Osimani, Larovere, Domenico, Ruggeri, Maurizio, Faldella, Giacomo, Baldi, Francesco, Badolato, Raffaele, Montagnani, Carlotta, Venturini, Elisabetta, Lisi, Catiuscia, Di Biagio, Antonio, Taramasso, Lucia, Giacomet, Vania, Erba, Paola, Esposito, Susanna, Lipreri, Rita, Salvini, Filippo, Tagliabue, Claudia, Cellini, Monica, Bruzzese, Eugenia, Lo Vecchio, Andrea, Rampon, Osvalda, Dona, Daniele, Romano, Amelia, Dodi, Icilio, Maccabruni, Anna, Consolini, Rita, Bernardi, Stefania, Kuekou, Hyppolite Tchidjou, Genovese, Orazio, Olmeo, Paolina, Cristiano, Letizia, Mazza, Antonio, Gabiano, Clara, Garazzino, Silvia, Pellegatta, Antonio, Pajkrt, D., Scherpbier, H. J., Weijsenfeld, A. M., de Boer, C. G., Jurriaans, S., Back, N. K. T., Zaaijer, H. L., Berkhout, B., Cornelissen, M. T. E., Schinkel, C. J., Wolthers, K. C., Fraaij, P. L. A., van Rossum, A. M. C., Vermont, C. L., van der Knaap, L. C., Visser, E. G., Boucher, C. A. B., Koopmans, M. P. G., van Kampen, J. J. A., Pas, S. D., Henriet, S. S., V, van de Flier, M., van Aerde, K., Strik-Albers, R., Rahamat-Langendoen, J., Stelma, F. F., Scholvinck, E. H., de Groot-de Jonge, H., Niesters, H. G. M., van Leer-Buter, C. C., Knoester, M., Bont, L. J., Geelen, S. P. M., Wolfs, T. F. W., Nauta, N., Schuurman, R., Verduyn-Lunel, F., Wensing, A. M. J., Reiss, P., Zaheri, S., Bezemer, D. O., van Sighem, A., I, Smit, C., Wit, F. W. M. N., Hillebregt, M., de Jong, A., Woudstra, T., Bergsma, D., Grivell, S., Meijering, R., Raethke, M., Rutkens, T., de Groot, L., van den Akker, M., Bakker, Y., Bezemer, M., El Berkaoui, A., Geerlinks, J., Koops, J., Kruijne, E., Lodewijk, C., Lucas, E., van der Meer, R., Munjishvili, L., Paling, E., Peeck, B., Ree, C., Regtop, R., Ruijs, Y., van de Sande, L., Schoorl, M., Schnorr, P., Tuijn, E., Veenenberg, L., van der Vliet, S., Wisse, A., Witte, E. C., Tuk, B., Popielska, Jolanta, Pokorska-Spiewak, Maria, Oldakowska, Agnieszka, Zawadka, Konrad, Coupland, Urszula, Doroba, Malgorzata, Voronin, Evgeny, Miloenko, Milana, Labutina, Svetlana, Soler-Palacin, Pere, Antoinette Frick, Maria, Perez-Hoyos, Santiago, Mur, Antonio, Lopez, Nuria, Mendez, Maria, Mayol, Lluis, Vallmanya, Teresa, Calavia, Olga, Garcia, Lourdes, Coll, Maite, Pineda, Valenti, Rius, Neus, Rovira, Nuria, Duenas, Joaquin, Gamell, Anna, Fortuny, Claudia, Noguera-Julian, Antoni, Jose Mellado, Maria, Escosa, Luis, Garcia Hortelano, Milagros, Sainz, Talia, Isabel Gonzalez-Tome, Maria, Rojo, Pablo, Blazquez, Daniel, Prieto, Luis, Guillen, Sara, Saavedra, Jesus, Santos, Mar, Angeles Munoz, Ma, Ruiz, Beatriz, Fernandez Mc Phee, Carolina, Jimenez de Ory, Santiago, Alvarez, Susana, Angel Roa, Miguel, Beceiro, Jose, Martinez, Jorge, Badillo, Katie, Apilanez, Miren, Pocheville, Itziar, Garrote, Elisa, Colino, Elena, Gomez Sirvent, Jorge, Garzon, Monica, Roman, Vicente, Montesdeoca, Abian, Mateo, Mercedes, Jose Munoz, Maria, Angulo, Raquel, Neth, Olaf, Falcon, Lola, Terol, Pedro, Luis Santos, Juan, Moreno, David, Lendinez, Francisco, Grande, Ana, Jose Romero, Francisco, Perez, Carlos, Lillo, Miguel, Losada, Begona, Herranz, Mercedes, Bustillo, Matilde, Guerrero, Carmelo, Collado, Pilar, Antonio Couceiro, Jose, Perez, Amparo, Isabel Piqueras, Ana, Breton, Rafael, Segarra, Inmaculada, Gavilan, Cesar, Jareno, Enrique, Montesinos, Elena, Dapena, Marta, Alvarez, Cristina, Gloria Andres, Ana, Marugan, Victor, Ochoa, Carlos, Alfayate, Santiago, Isabel Menasalvas, Ana, de Miguel, Elisa, Naver, Lars, Soeria-Atmadja, Sandra, Hagas, Vendela, Aebi-Popp, K., Anagnostopoulos, A., Asner, S., Battegay, M., Baumann, M., Bernasconi, E., Boni, J., Braun, D. L., Bucher, H. C., Calmy, A., Cavassini, M., Ciuffi, A., Duppenthaler, A., Dollenmaier, G., Egger, M., Elzi, L., Fehr, J., Fellay, J., Francini, K., Furrer, H., Fux, C. A., Grawe, C., Gunthard, H. F., Haerry, D., Hasse, B., Hirsch, H. H., Hoffmann, M., Hosli, I, Huber, M., Kahlert, C. R., Kaiser, L., Keiser, O., Klimkait, T., Kottanattu, L., Kouyos, R. D., Kovari, H., Ledergerber, B., Martinetti, G., de Tejada, Martinez B., Marzolini, C., Metzner, K. J., Mueller, N., Nicca, D., Paioni, P., Pantaleo, G., Perreau, M., Polli, Ch, Rauch, A., Rudin, C., Scherrer, A. U., Schmid, P., Speck, R., Stockle, M., Tarr, P., Lecompte, Thanh M., Trkola, A., Vernazza, P., Wagner, N., Wandeler, G., Weber, R., Wyler, C. A., Yerly, S., Wannarit, Pornpun, Techakunakorn, Pornchai, Hansudewechakul, Rawiwan, Wanchaitanawong, Vanichaya, Theansavettrakul, Sookchai, Nanta, Sirisak, Ngampiyaskul, Chaiwat, Phanomcheong, Siriluk, Hongsiriwon, Suchat, Karnchanamayul, Warit, Kwanchaipanich, Ratchanee, Kanjanavanit, Suparat, Kamonpakorn, Nareerat, Nantarukchaikul, Maneeratn, Layangool, Prapaisri, Mekmullica, Jutarat, Lucksanapisitkul, Paiboon, Watanayothin, Sudarat, Lertpienthum, Narong, Warachit, Boonyarat, Hanpinitsak, Sansanee, Potchalongsin, Sathit, Thanasiri, Pimpraphai, Krikajornkitti, Sawitree, Attavinijtrakarn, Pornsawan, Srirojana, Sakulrat, Bunjongpak, Suthunya, Puangsombat, Achara, Na-Rajsima, Sathaporn, Ananpatharachai, Pornchai, Akarathum, Noppadon, Lawtongkum, Weerasak, An, Prapawan Kheunj, Suriyaboon, Thitiporn, Saipanya, Airada, Than-in-at, Kanchana, Jaisieng, Nirattiya, Suaysod, Rapeepan, Chailoet, Sanuphong, Naratee, Naritsara, Kawilapat, Suttipong, Lyall, Hermione, Bamford, Alasdair, Butler, Karim, Doherty, Conor, Foster, Caroline, Francis, Kate, Harrison, Ian, Kenny, Julia, Klein, Nigel, Letting, Gillian, McMaster, Paddy, Murau, Fungai, Nsangi, Edith, Peters, Helen, Prime, Katia, Riordan, Andrew, Shackley, Fiona, Shingadia, Delane, Storey, Sharon, Tudor-Williams, Gareth, Turkova, Anna, Welch, Steve, Collins, Intira Jeannie, Cook, Claire, Dobson, Donna, Fairbrother, Keith, Harper, Lynda, Le Prevost, Marthe, Van Looy, Nadine, Butler, K., Walsh, A., Thrasyvoulou, L., Welch, S., Bernatoniene, J., Manyika, F., Sharpe, G., Subramaniam, B., Sloper, K., Fidler, K., Hague, R., Price, V, Clapson, M., Flynn, J., Abou-Rayyah, A. Cardoso M., Klein, N., Shingadia, D., Gurtin, D., Yeadon, S., Segal, S., Ball, C., Hawkins, S., Dowie, M., Bandi, S., Percival, E., Eisenhut, M., Duncan, K., Clough, S., Anguvaa, L., Conway, S., Flood, T., Pickering, A., Murphy, P. McMaster C., Daniels, J., Lees, Y., Thompson, F., Williams, B., Pope, S., Cliffe, L., Smyth, A., Southall, S., Freeman, A., Freeman, H., Christie, S., Gordon, A., Clarke, D. Rogahn L., Jones, L., Offerman, B., Greenberg, M., Benson, C., Riordan, A., Ibberson, L., Shackley, F., Faust, S. N., Hancock, J., Doerholt, K., Prime, K., Sharland, M., Storey, S., Lyall, H., Monrose, C., Seery, P., Tudor-Williams, G., Menson, E., Callaghan, A., Bridgwood, A., McMaster, P., Evans, J., Blake, E., Yannoulias, A., European Pregnancy Paediat HIV Coh, Microbes in Health and Disease (MHD), Fundación Investigación y Educación en Sida, Instituto de Salud Carlos III, European Commission, Fundación Mutua Madrileña, Épidémiologie clinique, santé mère-enfant et VIH en Asie du Sud-Est (IRD_PHPT), Harvard University [Cambridge]-Chiang Mai University (CMU), Pediatrics, and Virology

Subjects
0301 basic medicine, Male, Pediatrics, puberty, [SDV]Life Sciences [q-bio], humanos, Human immunodeficiency virus (HIV), adolescente, LETTONIE, CHILDREN, HIV Infections, medicine.disease_cause, GRECE, desarrollo del niño, Cohort Studies, 0302 clinical medicine, Child Development, CHILD_DEVELOPMENT, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, ADOLESCENTS, Immunology and Allergy, Pooled data, 030212 general & internal medicine, SUEDE, Child, estudios de cohortes, ESPAGNE, 11 Medical and Health Sciences, Anthropometry, THAILANDE, Europe, growth, height, HIV, perinatal, Thailand, Adolescent, Anti-Retroviral Agents, Child, Preschool, Female, Humans, Infant, Puberty, virus diseases, Growth spurt, PAYS BAS, 3. Good health, 17 Psychology and Cognitive Sciences, AIDS, antirretrovirales, Infectious Diseases, POLOGNE, BELGIQUE, Life Sciences & Biomedicine, medicine.medical_specialty, Pediatric hiv, Epidemiology and Social, ROYAUME UNI, Immunology, MASS, European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) study group, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Virology, medicine, pubertad, Preschool, lactante, ROUMANIE, Science & Technology, business.industry, 06 Biological Sciences, VELOCITY, SUISSE, Regimen, 030104 developmental biology, VIRAL LOAD, antropometría, infecciones por VIH, BODY_HEIGHT, business, IRLANDE, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

The European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) study group., [Objective]: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. [Design]: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. [Methods]: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1–10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. [Results]: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and −1.2 (IQR: −2.3 to −0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20–0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21–1.78) years later in those starting with HAZ less than −3 compared with HAZ at least −1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than −1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least −1, there was no association with age. Girls and boys who initiated ART with HAZ at least −1 maintained a similar height to the WHO reference mean. [Conclusion]: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least −1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age., This work has been partially funded by the Fundación para la Investigación y Prevención de SIDA en España (FIPSE) (FIPSE 3608229/09, FIPSE 240800/09, FIPSE 361910/10), Red Temática de Investigación en SIDA (RED RIS) supported by Instituto de Salud Carlos III (ISCIII) (RD12/0017/0035 and RD12/0017/0037), project as part of the Plan R+D+I and cofinanced by ISCIII- Subdirección General de Evaluación and Fondo Europeo de Desarrollo Regional (FEDER),Mutua Madrileña 2012/0077, Gilead Fellowship 2013/0071, FIS PI15/00694,CoRISpe (RED RIS RD06/0006/0035 y RD06/0006/0021).

Published
2019
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