Effect of HAART on growth parameters and absolute CD4 count among HIV-infected children in a rural community of central Nigeria

Abstract

Background:Monitoring response to highly active antiretroviral therapy (HAART) in HIV infected children using both laboratory and physical growth parameter is important. But monitoring laboratory parameters could sometimes be challenging in resource-poor settings as the machines used for these measurements may not always be functional or the required technical expertise be available especially in rural areas. Hence, changes in weight-for-age (WAZ), height-for -age (HAZ) and body mass indexfor age (BAZ) Z scores during clinic follow-up visits with or without changes in absolute CD4 count, could be used instead of viral load measurements as indicators of response to HAART in children.
Objectives: To determine the effect in children of treatment with HAART - on changes in physical growth using WAZ, HAZ and BAZ and on changes in CD4 count using absolute CD4 count.
Methods: Data on demographic/ clinical variables, viral load, absolute CD4 count, and weight and height measurements done at enrolment and at follow-up visits for 72 eligible children < 15 years who were consecutively enrolled into HAART were analysed
Results: After nine months of HAART, the median absolute CD4 count increased by 28.2% and median WAZ increased by 28.6%. The reduction in the proportion of children with moderate malnutrition (WAZ < -2) from time of HAART commencement to nine months after HAART, was by 61.5% in those without severe immune suppression (SIS) and by 50% in those with SIS
Conclusion: This study showed that WAZ and absolute CD4 count changes could be useful for monitoring response to HAART in resource –limited settings.

Key words: Growth, Absolute CD4 count, Z score, HAART