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Early Height and Weight Changes in Children Using Cotrimoxazole Prophylaxis With Antiretroviral Therapy

David C Boettiger1, Dina Muktiarti2, Nia Kurniati2

  • 1The Kirby Institute, University of New South Wales, Sydney, Australia.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|July 30, 2016
PubMed

Insights

Cotrimoxazole improves weight gain but not height in children starting antiretroviral therapy (ART). This finding is significant for underweight children with higher CD4 counts, suggesting targeted benefits for growth during early HIV treatment.

Area of Science:

  • Pediatric HIV/AIDS
  • Infectious Diseases
  • Growth and Development

Background:

  • The growth benefits of cotrimoxazole during early antiretroviral therapy (ART) in children are not well understood.
  • Early ART initiation is critical for children living with HIV.

Purpose of the Study:

  • To evaluate the impact of cotrimoxazole on growth metrics (height and weight) in children initiating ART.
  • To identify factors influencing cotrimoxazole's effect on growth outcomes.

Main Methods:

  • Analysis of 3217 children from the Therapeutics Research, Education, and AIDS Training in Asia Pediatric HIV Observational Database.
  • Generalized estimating equations used to assess changes in height-for-age z-score (HAZ) and weight-for-age z-score (WAZ).
  • Stratification by baseline CD4 percentage (CD4%) and nutritional status (stunted or underweight).

Main Results:

  • Cotrimoxazole did not significantly affect height-for-age z-score (HAZ) changes in the overall cohort.
  • Cotrimoxazole use was associated with improved weight-for-age z-score (WAZ) in children with baseline CD4% >10%.
  • Underweight children (WAZ < -2) with baseline CD4% ≥10% showed improved WAZ with cotrimoxazole use.

Conclusions:

  • Cotrimoxazole demonstrates significant benefits for weight gain (WAZ) but not height gain (HAZ) during early ART in Asian children.
  • The positive impact on weight is more pronounced in children with higher baseline CD4 percentages.
  • Findings suggest cotrimoxazole plays a role in nutritional recovery during HIV treatment, particularly for vulnerable children.
Abstract

Keywords:
antiretroviral therapychildrencotrimoxazoleheightweight

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