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Assessment of growth and immunologic function in HIV-infected and exposed children
Terri H Lipman1, Janet A Deatrick, Carole S Treston
1School of Nursing, University of Pennsylvania, Children's Hospital of Philadelphia, USA.
Insights
Children with human immunodeficiency virus (HIV) infection experience significant growth failure. Even those who clear the virus (seroreverters) show more growth issues than expected.
Area of Science:
- Pediatric Health
- Infectious Diseases
- Epidemiology
Background:
- Poor growth is a recognized complication in children with human immunodeficiency virus (HIV) infection.
- Understanding growth patterns in diverse pediatric HIV populations is crucial for clinical management.
Purpose of the Study:
- To assess and compare growth patterns in HIV-infected children, seroreverters, and deceased HIV-infected children.
- To identify factors associated with growth failure in pediatric HIV.
Main Methods:
- Retrospective chart review of 192 children, categorized into three groups: vertically HIV-infected, HIV seroreverters, and deceased HIV-infected.
- Epidemiological framework used to analyze growth parameters (linear growth and weight gain).
Main Results:
- HIV-infected children and seroreverters exhibited significantly greater growth failure compared to the general population.
- Poor weight gain was more prevalent in children with growth failure who subsequently died.
- HIV classification did not significantly correlate with growth outcomes.
Conclusions:
- Growth failure is a substantial issue in both perinatally HIV-infected children and seroreverters.
- Weight gain is a critical indicator, especially in children with severe growth failure and poor prognosis.
- Findings have implications for nursing practice and research in pediatric HIV care.
Abstract:
Many children who are HIV infected grow poorly. An epidemiological framework guided a retrospective chart review assessing growth in three groups of children (n = 192): (a) children who were HIV infected secondary to maternal transmission (n = 77), (b) children who had been HIV-positive at birth but became seronegative and continue to be observed (seroreverters) (n = 84), and (c) HIV-infected children who had died (n = 31). Growth failure in the HIV-infected children was significantly greater than that expected in the general population. The seroreverters also demonstrated significantly more growth failure than that expected in the general population. Of the children who had linear growth failure, only 3 of 12 HIV-infected children and 2 of 11 seroreverters also had inadequate weight gain. However, 13 of 15 children with growth failure who subsequently died had poor weight gain. HIV classification was not significantly related to growth. These findings extend our understanding to a large, urban population of children in the United States including those who are older than children in other studies and who developed HIV through perinatal transmission. Nursing clinical practice and research implications are offered.