PEDIATRICS Vol. 100 No. 1 July 1997, p. e7
Copyright ©1997 by the American Academy of Pediatrics

ELECTRONIC ARTICLE:
Growth Failure as a Prognostic Indicator of Mortality in Pediatric HIV Infection

Received May 8, 1996; accepted Oct 28, 1996.

Rahel Berhane^*, Danstan Bagenda, Lawrence Marum^§, Esther Aceng^¶, Christopher Ndugwa^¶, Ronald J Bosch, and Karen Olness^§

From the ^* New England Medical Center, Tufts University, Boston Massachusetts; the  Human Reproductive Research Unit, Department of Obstetrics and Gynaecology, Makerere University, Kampala, Uganda; the ^§ Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio; the ^¶ Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda; and the  Harvard School of Public Health, Boston, Massachusetts.

Objective.  To study the effect of perinatally acquired human immunodeficiency virus (HIV) on somatic growth and examine the relationship of nutritional status to mortality in HIV-infected infants.

Method.  Pregnant women attending the antenatal clinic at Mulago hospital in Kampala, Uganda, were enrolled. All live-born babies born to HIV-1 seropositive (HIV+) women, and to every fourth age-matched HIV-1 seronegative (HIV) woman, were followed for 25 months.

Results.  The mean weight-for-age and length-for-age curves of HIV+ children were significantly lower than those of HIV controls and seroeverters. Forty-five (54%) of the 84 HIV+ infants died before their second birthday, as compared with a 1.6% and 5.6% mortality in HIV and seroeverters. HIV+ infants with an average weight-for-age Z-score below 1.5 in the first year of life have a nearly fivefold risk of dying before 25 months of age compared with noninfected controls.

Conclusion.  Perinatally acquired HIV infection is associated with early and progressive growth failure. The severity of growth failure is associated with an increased risk of mortality. The effect of early, aggressive nutritional intervention in delaying HIV progression and mortality should be evaluated by controlled intervention studies.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J. B. Wolf Is Breast Really Best? Risk and Total Motherhood in the National Breastfeeding Awareness Campaign Journal of Health Politics Policy and Law, August 1, 2007; 32(4): 595 - 636. [Abstract] [PDF]

				J. M. Hopkinson Response to "Is Breast Really Best? Risk and Total Motherhood in the National Breast-Feeding Awareness Campaign" Journal of Health Politics Policy and Law, August 1, 2007; 32(4): 637 - 648. [PDF]

				C. Kjellgren, A. Wassberg, M. Carlberg, N. LAngstrom, and C. Goran Svedin Adolescent Sexual Offenders: A Total Survey of Referrals To Social Services in Sweden and Subgroup Characteristics Sexual Abuse: A Journal of Research and Treatment, October 1, 2006; 18(4): 357 - 372. [Abstract] [PDF]

				O Flidel-Rimon and E S Shinwell Breast feeding twins and high multiples. Arch. Dis. Child. Fetal Neonatal Ed., September 1, 2006; 91(5): F377 - F380. [Abstract] [Full Text] [PDF]

				C. C. Robinson and S. A. Rosenberg Child Welfare Referrals to Part C Journal of Early Intervention, July 1, 2004; 26(4): 284 - 291. [Abstract] [PDF]

				S. M. Arpadi, P. A. Cuff, D. P. Kotler, J. Wang, M. Bamji, M. Lange, R. N. Pierson, and D. E. Matthews Growth Velocity, Fat-Free Mass and Energy Intake Are Inversely Related to Viral Load in HIV-Infected Children J. Nutr., October 1, 2000; 130(10): 2498 - 2502. [Abstract] [Full Text]