Growth in human immunodeficiency virus type 1-infected children treated with protease inhibitors

To determine the long-term impact of antiretroviral treatment (ART) includi ng a protease inhibitor (PI) on growth in children infected with the human immunodeficiency virus type 1 (HIV-1), a prospective multi-centre study was conducted in Switzerland on HIV-1-infected children treated with ritonavir (350 mg/m(2) twice a day) or nelfinavir (20-30 mg/kg three times a day) in addition to two nucleoside reverse transcriptase inhibitors. Length or hei ght of HIV-1-infected children from before (weeks -72, -48, -24, and 0) and after (weeks +24, +48, and +72) introducing a PI to the ART were compared. To allow for age- and gender-independent assessment, values were expressed in standard deviations from the mean. Complete data sets on body length we re available for 44 children after 72 weeks of treatment with a PI. Precedi ng initiation of a PI, there was an overall decline in growth to -0.3 SD. F ollowing start of a PI, an increase in growth was noted from weeks 0 to +24 (+0.33 SD, P = 0.02) and from weeks +48 to + 72 (+0.21 SD, P = 0.03). The increase in growth was restricted to children with stunting before a PI was introduced (P = 0.03), and was more marked in children younger than 3 year s of age. Conclusion: children infected with human immunodeficiency virus t ype 1 showed catch-up growth after addition of a protease inhibitor to thei r antiretroviral treatment, but this phenomenon was observed almost exclusi vely in children under 3 years of age.