Influence of AIDS antiretroviral therapy on the growth pattern

J Pediatr (Rio J). 2019 Jan-Feb;95(1):7-17. doi: 10.1016/j.jped.2018.02.006. Epub 2018 Apr 13.

Abstract

Objectives: Human immunodeficiency virus infection can result in the early impairment of anthropometric indicators in children and adolescents. However, combined antiretroviral therapy has improved, in addition to the immune response and viral infection, the weight and height development in infected individuals. Therefore, the objective was to evaluate the effect of combined antiretroviral on the growth development of human immunodeficiency virus infected children and adolescents.

Source of data: A systematic review was performed. In the study, the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) strategy was used as the eligibility criterion. The MEDLINE-PubMed and LILACS databases were searched using these descriptors: HIV, children, growth, antiretroviral therapy. The objective was defined by the population, intervention, comparison/control, and outcome (PICO) technique. Inclusion and exclusion criteria were applied for study selection.

Synthesis of data: Of the 549 studies indexed in MEDLINE-PubMed and LILACS, 73 were read in full, and 44 were included in the review (33 showed a positive impact of combined antiretroviral therapy on weight/height development, ten on weight gain, and one on height gain in children and adolescents infected with human immunodeficiency virus). However, the increase in growth was not enough to normalize the height of infected children when compared to children of the same age and gender without human immunodeficiency virus infection.

Conclusions: Combined antiretroviral therapy, which is known to play a role in the improvement of viral and immunological markers, may influence in the weight and height development in children infected with human immunodeficiency virus. The earlier the infection diagnosis and, concomitantly, of malnutrition and the start of combined antiretroviral therapy, the lower the growth impairment when compared to healthy children.

Keywords: Antiretroviral therapy; Children; Crescimento; Crianças; Growth; HIV; Terapia antirretroviral.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active*
  • Body Height / drug effects*
  • Body Weight / drug effects*
  • Child
  • Child Development / drug effects*
  • Child, Preschool
  • Growth / drug effects*
  • HIV Infections / drug therapy*
  • Humans
  • Infant
  • Infant, Newborn
  • Young Adult

Substances

  • Anti-HIV Agents