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dc.contributor.authorMusoke, Philippa M.en_US
dc.contributor.authorMudiope, Peteren_US
dc.contributor.authorBarlow-Mosha, Linda N.en_US
dc.contributor.authorAjuna, Patricken_US
dc.contributor.authorBagenda, Danstanen_US
dc.contributor.authorMubiru, Michael M.en_US
dc.contributor.authorTylleskär, Thorkilden_US
dc.contributor.authorFowler, Mary G.en_US
dc.date.accessioned2011-11-09T12:51:45Z
dc.date.available2011-11-09T12:51:45Z
dc.date.issued2010-08-06eng
dc.identifier.issn1471-2431
dc.identifier.urihttps://hdl.handle.net/1956/5167
dc.description.abstractBackground: Scale up of paediatric antiretroviral therapy in resource limited settings continues despite limited access to routine laboratory monitoring. We documented the weight and height responses in HIV infected Ugandan children on highly active antiretroviral therapy and determined clinical factors associated with successful treatment outcomes. Methods: A prospective cohort of HIV infected children were initiated on HAART and followed for 48 weeks. Body mass index for age z scores(BAZ), weight and height-for-age z scores (WAZ & HAZ) were calculated: CD4 cell % and HIV-1 RNA were measured at baseline and every 12 weeks. Treatment outcomes were classified according to; both virological and immunological success (VS/IS), virological failure and immunological success (VF/IS). virological success and immunological failure (VS/IF) and both virological and immunological failure (VF/IF). Results: From March 2004 until May 2006, 124 HIV infected children were initiated on HAART. The median age (IQR) was 5.0 years (2.1 - 7.0) and 49% (61/124) were female. The median [95% confidence interval (CI)] BAZ, WAZ and HAZ at baseline were 0.29 (-2.9, -1.2), -1.2 (-2.1, -0.5) and -2.06 (-2.9, -1.2) respectively. Baseline median CD4 cell % and log10 HIV-1 RNA were; 11.8% (7.5-18.0) and 5.6 (5.2-5.8) copies/ml. By 48 weeks, mean WAZ and HAZ in the VF/IS group, which was younger, increased from - 0.98 (SD 1.7) to + 1.22 (SD 1.2) and from -1.99 (1.7) to + 0.76 (2.4) respectively. Mean increase in WAZ and HAZ in the VS/IF group, an older group was modest, from -1.84 (1.3) to - 0.41 (1.2) and -2.25 (1.2) to -1.16 (1.3) respectively. Baseline CD4 cell % [OR 6.97 95% CI (2.6 -18.6)], age [OR 4.6 95% CI (1.14 -19.1)] and WHO clinical stage [OR 3.5 95%CI (1.05 -12.7)] were associated with successful treatment outcome. Conclusions: HIV infected Ugandan children demonstrated a robust increase in height and weight z scores during the first 48 weeks of HAART, including those who failed to completely suppress virus. Older children initiating HAART with severe immune suppression were less likely to achieve a successful treatment outcome. These data emphasize the importance of initiating HAART early to ensure adequate immune and growth responses.en_US
dc.language.isoengeng
dc.publisherBioMed Centraleng
dc.relation.ispartof<a href="http://hdl.handle.net/1956/5168" target="blank">Paediatric HIV-1 infection in Uganda. Natural history and early antiretroviral treatment response </a>eng
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/eng
dc.titleGrowth, immune and viral responses in HIV infected African children receiving highly active antiretroviral therapy: a prospective cohort studyen_US
dc.typePeer reviewed
dc.typeJournal article
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright the author. All rights reserved
dc.source.articlenumber56
dc.identifier.doihttps://doi.org/10.1186/1471-2431-10-56
dc.identifier.cristin533418
dc.source.journalBMC Pediatrics
dc.source.4010
dc.subject.nsiVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Communicable diseases: 776eng


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