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Improved growth and anemia in HIV-infected African children taking cotrimoxazole prophylaxis

Andrew Prendergast1, A Sarah Walker, Veronica Mulenga

  • 1MRC Clinical Trials Unit, London, United Kingdom. ajp@ctu.mrc.ac.uk

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|March 24, 2011
PubMed

Insights

Cotrimoxazole (CTX) prophylaxis improved growth and reduced anemia in HIV-infected children in Zambia. Early CTX use is recommended for better health outcomes in this vulnerable population.

Area of Science:

  • Pediatric infectious diseases
  • HIV/AIDS research
  • Nutritional epidemiology

Background:

  • Human immunodeficiency virus (HIV) infection significantly impacts child development.
  • Antiretroviral therapy (ART) is crucial but may not be initiated early in all settings.
  • Growth faltering and anemia are common complications in HIV-infected children.

Purpose of the Study:

  • To evaluate the effect of cotrimoxazole (CTX) prophylaxis on growth and anemia.
  • To assess the impact of CTX in HIV-infected, ART-naive children.
  • To inform clinical guidelines for CTX use in pediatric HIV.

Main Methods:

  • Prospective study of 541 HIV-infected, ART-naive children in Zambia.
  • Randomized controlled trial comparing CTX prophylaxis versus placebo.
  • Monitoring of weight-for-age, height-for-age, and hemoglobin levels.

Main Results:

  • Children receiving CTX showed slower decreases in weight-for-age (P=.04).
  • CTX group exhibited slower decreases in height-for-age (P=.01).
  • Significantly greater increase in hemoglobin levels was observed in the CTX group (P=.01).

Conclusions:

  • Early cotrimoxazole prophylaxis positively impacts growth parameters in HIV-infected children.
  • CTX significantly improves hemoglobin levels, mitigating anemia.
  • Findings support expanded early use of CTX in this population.

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