Format du dépôt |
Fichier |
Type de dépôt |
Article dans une revue |
Titre |
en
Early treated HIV-infected children remain at risk of growth retardation during the first five years of life: Results from the ANRS-PEDIACAM cohort in Cameroon
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Résumé |
en
Background
Long-term growth in HIV-infected infants treated early in resource-limited settings is poorly documented. Incidence of growth retardation, instantaneous risk of death related to malnutrition and growth parameters evolution during the first five years of life of uninfected and early treated HIV-infected children were compared and associated factors with growth retardation were identified.
Methods
Weight-for-age (WAZ), weight-for-length (WLZ), and length-for-age (LAZ) Z-scores were calculated. The ANRS-PEDIACAM cohort includes four groups of infants with three enrolled during the first week of life: HIV-infected (HI, n = 69), HIV-exposed uninfected (HEU, n = 205) and HIV-unexposed uninfected (HUU, n = 196). The last group included HIV-infected infants diagnosed before 7 months of age (HIL, n = 141). The multi-state Markov model was used to describe the incidence of growth retardation and identified associated factors.
Results
During the first 5 years, 27.5% of children experienced underweight (WAZ<-2), 60.4% stunting (LAZ<-2) and 41.1% wasting (WLZ<-2) at least once. The instantaneous risk of death observed from underweight state (35.3 [14.1–88.2], 84.0 [25.5–276.3], and 6.0 [1.5–24.1] per 1000 person-months for 0–6 months, 6–12 months, and 12–60 months respectively) was higher than from non-underweight state (9.6 [5.7–16.1], 20.1 [10.3–39.4] and 0.3 [0.1–0.9] per 1000 person-months). Compared to HEU, HIL and HI children were most at risk of wasting (adjusted HR (aHR) = 4.3 (95%CI: 1.9–9.8), P<0.001 and aHR = 3.3 (95%CI: 1.4–7.9), P = 0.01 respectively) and stunting for HIL (aHR = 8.4 (95%CI: 2.4–29.7). The risk of underweight was higher in HEU compared to HUU children (aHR = 5.0 (CI: 1.4–10.0), P = 0.001). Others associated factors to growth retardation were chronic pathologies, small size at birth, diarrhea and CD4< 25%.
Conclusions
HIV-infected children remained at high risk of wasting and stunting within the first 5 years period of follow-up. There is a need of identifying suitable nutritional support and best ways to integrate it with cART in pediatric HIV infection global care.
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Auteur(s)
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Casimir Ledoux Sofeu
1, 2, 3, 4
, Mathurin Cyrille Tejiokem
3
, Calixte Ida Penda
5
, Camelia Protopopescu
1
, Francis Ateba Ndongo
6
, Suzie Tetang Ndiang
7
, Georgette Guemkam
6
, Josiane Warszawski
8
, Albert Faye
9, 10
, Roch Giorgi
1, 11
1
SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD -
Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
( 541536 )
- Faculté de Médecine - Site Timone - 27 Bd Jean Moulin 13385 Marseille Cedex 05.
- France
-
Institut de Recherche pour le Développement UMR 259 ( 67872 )
;
-
Aix Marseille Université ( 198056 )
;
-
Institut National de la Santé et de la Recherche Médicale U1252 ( 303623 )
2
ISPED -
Institut de Santé Publique, d'Epidémiologie et de Développement
( 8402 )
- 146 rue Léo Signat 33076 Bordeaux Cedex
- France
-
Université Bordeaux Segalen - Bordeaux 2 ( 91134 )
3
Laboratoire d'Epidémiologie et de Santé Publique
( 135668 )
- Yaoundé
- Cameroun
-
Centre Pasteur du Cameroun ( 55917 )
;
-
Réseau International des Instituts Pasteur ( 301247 )
4
BPH -
Bordeaux population health
( 476572 )
- Université de Bordeaux - Case 11 - 146 rue Léo Saignat 33076 Bordeaux cedex
- France
-
Université de Bordeaux ( 259761 )
;
-
Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) ( 302259 )
;
-
Institut National de la Santé et de la Recherche Médicale U1219 ( 303623 )
5
Université de Douala
( 217369 )
- B.P. 2701 Douala
- Cameroun
6
FCB -
Fondation Chantal Biya
( 313993 )
- Yaoundé, Cameroon
- Cameroun
7
Centre Hospitalier Essos [Yaoundé, Cameroun]
( 129092 )
- Yaoundé
- Cameroun
8
CESP -
Centre de recherche en épidémiologie et santé des populations
( 106188 )
- 16 avenue Paul Vaillant Couturier 94807 Villejuif Cedex, France
- France
-
Université de Versailles Saint-Quentin-en-Yvelines UMR U1018 ( 81173 )
;
-
Université Paris-Sud - Paris 11 ( 92966 )
;
-
Assistance publique - Hôpitaux de Paris (AP-HP) ( 300068 )
;
-
Hôpital Paul Brousse ( 300153 )
;
-
Institut National de la Santé et de la Recherche Médicale U1018 ( 303623 )
9
Service de Pédiatrie, Hopital Robert Debré (APHP)
( 175980 )
- Paris
- France
-
Université Paris Diderot - Paris 7 ( 300301 )
10
ECEVE (U1123 / UMR_S_1123) -
Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables
( 1005005 )
- 48 Boulevard Sérurier 75019 Paris
- France
-
Institut National de la Santé et de la Recherche Médicale U1123 ( 303623 )
;
-
AP-HP Hôpital universitaire Robert-Debré [Paris] ( 426105 )
;
-
Assistance publique - Hôpitaux de Paris (AP-HP) ( 300068 )
;
-
Université Paris Cité UMR_S_1123 ( 557826 )
11
BiosTIC -
Biostatistique et technologies de l'information et de la communication (BioSTIC) - [Hôpital de la Timone - APHM]
( 432718 )
- Hôpital de la Timone – Bât G – 1er étage
- France
-
Assistance Publique - Hôpitaux de Marseille ( 300073 )
;
-
Hôpital de la Timone [CHU - APHM] ( 300093 )
|
Licence |
Paternité
|
Langue du document |
Anglais
|
Nom de la revue |
|
Vulgarisation |
Non
|
Comité de lecture |
Oui
|
Audience |
Internationale
|
Date de publication |
2019-07-18
|
Volume |
14
|
Numéro |
7
|
Page/Identifiant |
e0219960
|
Domaine(s) |
-
Sciences du Vivant [q-bio]/Santé publique et épidémiologie
|
Mots-clés |
en
HIV infections, Children, HIV diagnosis and management, Infants, Growth restriction, Anemia, Malnutrition, Human evolution
|
DOI |
10.1371/journal.pone.0219960 |
Pubmed Id |
31318938 |
PubMed Central |
PMC6638950 |