Skip to main content
Journal cover image

Antiretroviral therapy for HIV-1 infected adolescents in Uganda: Assessing the impact on growth and sexual maturation

Publication ,  Journal Article
Bakeera-Kitaka, S; McKellar, M; Snider, C; Kekitiinwa, A; Piloya, T; Musoke, P; Ronald, A; Javanbakht, M; Colebunders, R
Published in: Journal of Pediatric Infectious Diseases
June 25, 2008

There is a paucity of knowledge about perinatally infected human immunodeficiency virus (HIV) positive children surviving into their adolescent years, especially from sub-Saharan Africa. Although studies have described the effects of the disease on the physical and sexual maturation of this population, their response to highly active antiretroviral therapy has not been systematically studied. At the pediatric infectious diseases clinic in Mulago hospital, Kampala, Uganda, we evaluated the effect of antiretroviral therapy (ART) on 118 treatment-naive, perinatally-infected HIV positive adolescents between the ages of 10-19 for 12 months. We monitored physical growth using The Centers for Disease Control and Prevention and recently published World Health Organization (WHO) reference growth standards for height and weight measurements as well as sexual maturation using Tanner staging. Laboratory tests including: complete blood count, absolute CD4 cell count and percentage, and HIV-1 RNA viral load, were performed at baseline and at 3-month intervals. Of 118 children, 64% were female; the median age was 13.6 years old. At baseline, 75% were classified as WHO clinical stages III and IV, with a median CD4 count of 124 cells/ul. Apart from four adolescents, all were on first-line antiretroviral therapy with 2 nucleoside reverse transcriptase inhibitors and 1 non-nucleoside reverse transcriptase inhibitors. After 6 months, the median CD4 count was 304 cells/μL, increasing to 370 cells/μL, by 12 months. Antiretroviral therapy was virologically suppressive (HIV-1 RNA viral load <400 copies/mL) in 79% of the adolescents at 6 months and in 89% at 12 months. Six (5%) patients died during the 12-month study. The median baseline height for age Z score was -2.41 which improved to a median of -1.96 by 12 months (P < 0.0001). The median baseline weight for age Z score was -2.61 and improved to -1.26 by 12 months (P < 0.0001). The median body mass index Z score increased from -1.39 to -0.47 by 12 months (P < 0.0001). At baseline, 63% of the adolescents were noted to have delayed pubertal maturation; this only reduced slightly to 60% after 12 months. Adolescents with predominantly perinatally-acquired HIV infection and significant disease burden showed appropriate virologic and immunological response to ART in addition to having clinically significant improvements in growth and some improvement in sexual maturation. © 2008 IOS Press. All rights reserved.

Duke Scholars

Published In

Journal of Pediatric Infectious Diseases

ISSN

1305-7707

Publication Date

June 25, 2008

Volume

3

Issue

2

Start / End Page

97 / 104

Related Subject Headings

  • 1114 Paediatrics and Reproductive Medicine
  • 1108 Medical Microbiology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bakeera-Kitaka, S., McKellar, M., Snider, C., Kekitiinwa, A., Piloya, T., Musoke, P., … Colebunders, R. (2008). Antiretroviral therapy for HIV-1 infected adolescents in Uganda: Assessing the impact on growth and sexual maturation. Journal of Pediatric Infectious Diseases, 3(2), 97–104.
Bakeera-Kitaka, S., M. McKellar, C. Snider, A. Kekitiinwa, T. Piloya, P. Musoke, A. Ronald, M. Javanbakht, and R. Colebunders. “Antiretroviral therapy for HIV-1 infected adolescents in Uganda: Assessing the impact on growth and sexual maturation.” Journal of Pediatric Infectious Diseases 3, no. 2 (June 25, 2008): 97–104.
Bakeera-Kitaka S, McKellar M, Snider C, Kekitiinwa A, Piloya T, Musoke P, et al. Antiretroviral therapy for HIV-1 infected adolescents in Uganda: Assessing the impact on growth and sexual maturation. Journal of Pediatric Infectious Diseases. 2008 Jun 25;3(2):97–104.
Bakeera-Kitaka, S., et al. “Antiretroviral therapy for HIV-1 infected adolescents in Uganda: Assessing the impact on growth and sexual maturation.” Journal of Pediatric Infectious Diseases, vol. 3, no. 2, June 2008, pp. 97–104.
Bakeera-Kitaka S, McKellar M, Snider C, Kekitiinwa A, Piloya T, Musoke P, Ronald A, Javanbakht M, Colebunders R. Antiretroviral therapy for HIV-1 infected adolescents in Uganda: Assessing the impact on growth and sexual maturation. Journal of Pediatric Infectious Diseases. 2008 Jun 25;3(2):97–104.
Journal cover image

Published In

Journal of Pediatric Infectious Diseases

ISSN

1305-7707

Publication Date

June 25, 2008

Volume

3

Issue

2

Start / End Page

97 / 104

Related Subject Headings

  • 1114 Paediatrics and Reproductive Medicine
  • 1108 Medical Microbiology