Weight gain in children from birth to 10 years on antiretroviral treatment

BACKGROUND: Inadequate weight gain could indicate clinical deterioration in infants and children living with HIV (CLHIV). The World Health Organization’s (WHO) weight-for-age z-score (WAZ) growth standards and reference charts are currently used in South Africa to assess weight gain in CLHIV on antiretroviral treatment (ART). OBJECTIVES: To assess weight gain patterns of infants and children initiated on ART and to compare weight gain patterns between the WHO WAZ growth standards and population-specific curves constructed from data of CLHIV on ART. METHOD: A quantitative, retrospective and descriptive-comparative design was used. The weight gain patterns of 98 infants and children from birth to 10 years old during the 24-month period following ART initiation were recorded and assessed using two different growth charts. RESULTS: The children’s rate of weight and length gain improved significantly over 24 months since ART initiation, but complete catch-up growth was never achieved. Most (69%) of the children had increased weight gain according to the WAZ growth standard and reference charts versus only 16% according to the HIV-specific weight gain curves. CONCLUSION: Antiretroviral treatment improved weight and height gain in CLHIV, but the interpretations of weight gain differed significantly between the WHO chart and HIV-specific weight gain curves. Population- and treatment-specific references could improve weight monitoring in CLHIV and assist in the timeous identification of malnutrition.