Objective: The aim of this study was to describe growth during puberty in young
people with vertically acquired HIV.
Design: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand.
Methods: One thousand and ninety-four children initiating a nonnucleoside reverse
transcriptase inhibitor or boosted protease inhibitor based regimen aged 1–10 years
were included. Super Imposition by Translation And Rotation (SITAR) models described
growth from age 8 years using three parameters (average height, timing and shape of the
growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at
antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics
associated with these three parameters.
Results: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8,
9.0] years and 1.2 (IQR: 2.3 to 0.2), respectively. Median follow-up was 9.1 (IQR:
6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently
associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20–
0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years
and 1.50 (1.21–1.78) years later in those starting with HAZ less than 3 compared with
HAZ at least 1. Later growth spurts in girls resulted in continued height growth into
later adolescence. In boys starting ART with HAZ less than 1, growth spurts were later
in children starting ART in the oldest age group, but for HAZ at least 1, there was no
association with age. Girls and boys who initiated ART with HAZ at least 1 maintained
a similar height to the WHO reference mean.
Conclusion: Stunting at ART initiation was associated with later growth spurts in girls.
Children with HAZ at least 1 at ART initiation grew in height at the level expected in
HIV negative children of a comparable age