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Abstracts of Poster and e-Poster Presentations
PA-121 Relative growth rates for height among children and adolescents living with HIV on antiretroviral therapy
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  1. Tafadzwa Madanhire1,2,
  2. Victoria Simms1,2,
  3. Cynthia Mukwasi-Kahari1,2,
  4. Nyasha Dzavakwa1,2,
  5. Farirayi Kowo-Nyakoko1,2,
  6. Rashida A Ferrand1,2,
  7. Kate Ward3,4,
  8. Nuredin Mohammed2,4,
  9. Amy MacDougall2,
  10. Celia Gregson2,5
  1. 1Biomedical Research And Training Institute, Zimbabwe
  2. 2London School of Hygiene and Tropical Medicine, UK
  3. 3University of Southampton, UK
  4. 4MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Gambia
  5. 5University of Bristol, UK

Abstract

Background Perinatally acquired HIV is a treatable chronic condition such that through antiretroviral therapy (ART), children with HIV (CWH) are now surviving to adulthood. However, CWH often exhibit impaired growth. We aimed to identify the height growth patterns among CWH and determine age at peak-height-velocity (PHV).

Methods This is a secondary analysis of data collected prospectively in the ongoing VITALITY randomised controlled trial in Zimbabwe (EDCTP: VITALITY-RIA2018CO-2512). The trial has recruited 840 CWH (11–19 years) established on ART for at least 6 months, to determine whether vitamin-D3/calcium supplementation improves bone mass and strength with follow-up to 96 weeks. Height is measured at 12-week intervals with currently (31-March-2023) 135 participants having completed 96-weeks of follow-up. Weight and height for age were calculated using 1990-UK-reference values, with Z-score≤-2 classifying those underweight and stunted. Analysis of height trajectories was performed using the Superimposition by translation and rotation (SITAR) adjusting for size, pubertal-timing and growth-rate and fitting the mean and velocity curves by sex.

Results We recruited 447(53.2%) females and 393(46.8%) males and followed them up for 1.37(IQR:1.15–1.1.61) years; at baseline median (IQR) age was 15(13–17) years and 30.0%(n=252) were stunted. CHW were taking ART for median (IQR) 9.8(6.3–12.3) years of their lives and 81.9%(n=688) were on an ART regimen containing tenofovir-disoproxil-fumarate. Lifetime fracture prevalence was 5.9%(n=50). At baseline (n=840), mean (SD) height-for-age was -1.70(1.06) and -1.22(1.05) for males and females respectively. Over 48-weeks (n=780), median (IQR) height gains were 3.3(1.1–5.9) cm and 1.2(0.3–3.5) cm for males and females separately. Age at PHV was 15.0 years (PHV:8.2cm/year) and 13.2 years (PHV:5.6cm/year) for males and females respectively.

Conclusion There is a high prevalence of stunting among CWH in Zimbabwe. Both males and females showed delayed PHV compared to regional estimates (females:11.8, males:14.4 years), raising concerns for persistent height deficits in adulthood known to impact human capital and function in later life.

https://doi.org/10.1136/bmjgh-2023-EDC.93

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