Nachman Sharon A, Lindsey Jane C, Moye Jack, Stanley Kenneth E, Johnson George M, Krogstad Paul A, Wiznia Andrew A
Department of Pediatrics, State University of New York Health Science Center at Stony Brook, Stony Brook, NY 11794, USA.
Pediatr Infect Dis J. 2005 Apr;24(4):352-7. doi: 10.1097/01.inf.0000157095.75081.43.
Weight and height growth of HIV-infected children tends to lag behind that of uninfected children of similar age. Previous reports of the effect of highly active antiretroviral therapy (HAART) on the growth of HIV-infected children have been contradictory.
Age- and gender-adjusted height and weight z scores were studied for 192 HIV-infected children, 4 months to 17 years of age, who had been treated with antiretroviral therapy for at least 16 weeks. These children, in clinically and immunologically stable condition, were enrolled into one of 4 HAART regimens and evaluated for 96 weeks.
At baseline, these HIV-infected children were significantly shorter than uninfected children (mean z score, -0.57; 95% confidence interval, -0.73 to -0.41; P < 0.001). Children with greater viral loads at baseline were significantly shorter and lighter than children with smaller viral loads (both P < 0.001). Administration of HAART led to an increase in mean weight z scores to normal values (mean z score increase, from -0.16 to >0) by week 48 and an increase in mean height z scores of 72% toward normal values (mean z score increase, from -0.57 to -0.16) by week 96. Younger children gained height more rapidly (P < 0.001), and children with greater baseline viral loads gained weight more rapidly (P < 0.001). There was no evidence of differential height or weight changes in 48 weeks between children with different degrees of virologic control.
HAART improved the average weight gain of HIV-infected children from subnormal to normal after 1 year and improved average height growth to nearly normal after 2 years.
感染HIV的儿童的体重和身高增长往往落后于同龄未感染儿童。先前关于高效抗逆转录病毒疗法（HAART）对感染HIV儿童生长影响的报告相互矛盾。
对192名年龄在4个月至17岁、接受抗逆转录病毒治疗至少16周的感染HIV儿童进行了年龄和性别调整后的身高和体重z评分研究。这些临床和免疫状况稳定的儿童被纳入4种HAART方案之一，并接受了96周的评估。
基线时，这些感染HIV的儿童明显比未感染儿童矮（平均z评分，-0.57；95%置信区间，-0.73至-0.41；P<0.001）。基线病毒载量较高的儿童明显比病毒载量较低的儿童更矮更轻（均P<0.001）。HAART治疗使平均体重z评分在第48周时增至正常水平（平均z评分增加，从-0.16增至>0），平均身高z评分在第96周时向正常水平增加了72%（平均z评分增加，从-0.57增至-0.16）。年龄较小的儿童身高增长更快（P<0.001），基线病毒载量较高的儿童体重增加更快（P<0.001）。没有证据表明不同程度病毒学控制的儿童在48周内身高或体重变化存在差异。
HAART使感染HIV的儿童在1年后平均体重从低于正常水平增至正常水平，并在2年后使平均身高增长接近正常水平。
