The effect of protease inhibitor therapy on growth and body composition in human immunodeficiency virus type 1-infected children.

Tracie L Miller, B. E. Mawn, E. J. Orav, D. Wilk, G. A. Weinberg, J. Nicchitta, L. Furuta, R. Cutroni, K. McIntosh, S. K. Burchett, S. L. Gorbach

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Abstract

OBJECTIVE: To determine the effect of protease inhibitors (PIs) on growth and body composition in children with human immunodeficiency virus type 1 (HIV-1) infection. BACKGROUND: HIV-1-infected children have chronic problems with both linear growth and weight gain. Viral load may directly influence growth and nutritional status of HIV-1-infected children with reduction of viral load improving the nutritional condition. DESIGN/METHODS: Data from 67 patients who initiated PI therapy between 1996 and 1999 and who were enrolled in a prospective, longitudinal study of growth and nutrition in HIV-1-infected children were analyzed. Outcomes included pre-PI versus post-PI measures of height, weight, weight-for-height, triceps skinfold thickness, and arm muscle circumference. Predictor covariates included age, race, gender, Tanner stage, CD4 z score, Centers for Disease Control and Prevention stage, route of infection, plasma HIV-1 RNA, other antiretroviral therapy, recommended daily allowances for calories, treatment with megestrol acetate, and PI therapy. RESULTS: Sixty-seven children were followed for a median of 2.4 years with a total of 362 visits (median: 5 visits; range: 1-12). During follow-up, they received PIs for a median of 5 months. Fifty-one percent were girls, 54% black, 15% Hispanic, and 25% white. The mean age at first visit was 6.8 years. In a univariate analysis, weight z score (-0.67 to -0.35) and weight/height z score (0.25-0.76) improved on PI therapy. Using repeated-measures regression analysis, controlling for the above named covariates, PI treatment showed a significant effect on weight z score (increase in z score by 0.46), weight/height z score (increase in z score by 0.49), and arm muscle circumference (increase in percentile by 11.5). A borderline effect was found for height z score (increase in z score by 0.17) and no effect was found for triceps skinfold thickness. In a separate analysis, PI therapy increased CD4 counts twofold and reduced plasma HIV-1 RNA copies by 79%. CONCLUSION: In addition to a significant reduction in viral load, PI therapy in children has a positive effect on several growth parameters, including weight, weight/height, and muscle mass.

Original languageEnglish
JournalPediatrics
Volume107
Issue number5
StatePublished - May 1 2001
Externally publishedYes

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Body Composition
Protease Inhibitors
HIV-1
Weights and Measures
Growth
Viral Load
Therapeutics
Skinfold Thickness
Muscles
Megestrol Acetate
RNA
Recommended Dietary Allowances
Virus Diseases
Centers for Disease Control and Prevention (U.S.)
CD4 Lymphocyte Count
Nutritional Status
Hispanic Americans
Weight Gain
Longitudinal Studies
Regression Analysis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Miller, T. L., Mawn, B. E., Orav, E. J., Wilk, D., Weinberg, G. A., Nicchitta, J., ... Gorbach, S. L. (2001). The effect of protease inhibitor therapy on growth and body composition in human immunodeficiency virus type 1-infected children. Pediatrics, 107(5).

The effect of protease inhibitor therapy on growth and body composition in human immunodeficiency virus type 1-infected children. / Miller, Tracie L; Mawn, B. E.; Orav, E. J.; Wilk, D.; Weinberg, G. A.; Nicchitta, J.; Furuta, L.; Cutroni, R.; McIntosh, K.; Burchett, S. K.; Gorbach, S. L.

In: Pediatrics, Vol. 107, No. 5, 01.05.2001.

Research output: Contribution to journalArticle

Miller, TL, Mawn, BE, Orav, EJ, Wilk, D, Weinberg, GA, Nicchitta, J, Furuta, L, Cutroni, R, McIntosh, K, Burchett, SK & Gorbach, SL 2001, 'The effect of protease inhibitor therapy on growth and body composition in human immunodeficiency virus type 1-infected children.', Pediatrics, vol. 107, no. 5.
Miller, Tracie L ; Mawn, B. E. ; Orav, E. J. ; Wilk, D. ; Weinberg, G. A. ; Nicchitta, J. ; Furuta, L. ; Cutroni, R. ; McIntosh, K. ; Burchett, S. K. ; Gorbach, S. L. / The effect of protease inhibitor therapy on growth and body composition in human immunodeficiency virus type 1-infected children. In: Pediatrics. 2001 ; Vol. 107, No. 5.
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abstract = "OBJECTIVE: To determine the effect of protease inhibitors (PIs) on growth and body composition in children with human immunodeficiency virus type 1 (HIV-1) infection. BACKGROUND: HIV-1-infected children have chronic problems with both linear growth and weight gain. Viral load may directly influence growth and nutritional status of HIV-1-infected children with reduction of viral load improving the nutritional condition. DESIGN/METHODS: Data from 67 patients who initiated PI therapy between 1996 and 1999 and who were enrolled in a prospective, longitudinal study of growth and nutrition in HIV-1-infected children were analyzed. Outcomes included pre-PI versus post-PI measures of height, weight, weight-for-height, triceps skinfold thickness, and arm muscle circumference. Predictor covariates included age, race, gender, Tanner stage, CD4 z score, Centers for Disease Control and Prevention stage, route of infection, plasma HIV-1 RNA, other antiretroviral therapy, recommended daily allowances for calories, treatment with megestrol acetate, and PI therapy. RESULTS: Sixty-seven children were followed for a median of 2.4 years with a total of 362 visits (median: 5 visits; range: 1-12). During follow-up, they received PIs for a median of 5 months. Fifty-one percent were girls, 54{\%} black, 15{\%} Hispanic, and 25{\%} white. The mean age at first visit was 6.8 years. In a univariate analysis, weight z score (-0.67 to -0.35) and weight/height z score (0.25-0.76) improved on PI therapy. Using repeated-measures regression analysis, controlling for the above named covariates, PI treatment showed a significant effect on weight z score (increase in z score by 0.46), weight/height z score (increase in z score by 0.49), and arm muscle circumference (increase in percentile by 11.5). A borderline effect was found for height z score (increase in z score by 0.17) and no effect was found for triceps skinfold thickness. In a separate analysis, PI therapy increased CD4 counts twofold and reduced plasma HIV-1 RNA copies by 79{\%}. CONCLUSION: In addition to a significant reduction in viral load, PI therapy in children has a positive effect on several growth parameters, including weight, weight/height, and muscle mass.",
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AU - Weinberg, G. A.

AU - Nicchitta, J.

AU - Furuta, L.

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N2 - OBJECTIVE: To determine the effect of protease inhibitors (PIs) on growth and body composition in children with human immunodeficiency virus type 1 (HIV-1) infection. BACKGROUND: HIV-1-infected children have chronic problems with both linear growth and weight gain. Viral load may directly influence growth and nutritional status of HIV-1-infected children with reduction of viral load improving the nutritional condition. DESIGN/METHODS: Data from 67 patients who initiated PI therapy between 1996 and 1999 and who were enrolled in a prospective, longitudinal study of growth and nutrition in HIV-1-infected children were analyzed. Outcomes included pre-PI versus post-PI measures of height, weight, weight-for-height, triceps skinfold thickness, and arm muscle circumference. Predictor covariates included age, race, gender, Tanner stage, CD4 z score, Centers for Disease Control and Prevention stage, route of infection, plasma HIV-1 RNA, other antiretroviral therapy, recommended daily allowances for calories, treatment with megestrol acetate, and PI therapy. RESULTS: Sixty-seven children were followed for a median of 2.4 years with a total of 362 visits (median: 5 visits; range: 1-12). During follow-up, they received PIs for a median of 5 months. Fifty-one percent were girls, 54% black, 15% Hispanic, and 25% white. The mean age at first visit was 6.8 years. In a univariate analysis, weight z score (-0.67 to -0.35) and weight/height z score (0.25-0.76) improved on PI therapy. Using repeated-measures regression analysis, controlling for the above named covariates, PI treatment showed a significant effect on weight z score (increase in z score by 0.46), weight/height z score (increase in z score by 0.49), and arm muscle circumference (increase in percentile by 11.5). A borderline effect was found for height z score (increase in z score by 0.17) and no effect was found for triceps skinfold thickness. In a separate analysis, PI therapy increased CD4 counts twofold and reduced plasma HIV-1 RNA copies by 79%. CONCLUSION: In addition to a significant reduction in viral load, PI therapy in children has a positive effect on several growth parameters, including weight, weight/height, and muscle mass.

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