Patterns of linear growth among children and adolescents living with HIV on antiretroviral therapy in Zimbabwe and Zambia

• DOI: 10.1186/s12879-025-10669-0
• Publication Date: 2025-02-25T07:35:37Z
• Authors: Tafadzwa Madanhire; Amy Macdougall; Lackson Kasonka; Hildah B. Mabuda; Molly Chisenga; Hilda Mujuru; Tsitsi Bandason; Nyasha V. Dzavakwa; Victoria Simms; Kate A. Ward; Rashida A. Ferrand; Nuredin Mohammed; Celia L. Gregson
• Keywords: Medical microbiology; Parasitology; Tropical Medicine

Adolescents with HIV (AWH) frequently exhibit impaired growth, which manifests as stunting and wasting. We studied trajectories in leg-length (appendicular), sitting (axial), standing height among AWH on antiretroviral therapy (ART), determining peak velocity (PHV) age at PHV (aPHV). Analyses used VITALITY trial data from Zimbabwe Zambia (PACTR20200989766029), recruited (11-19 years) established ART to determine whether vitamin D3/calcium supplementation improves bone health. The study enrolled participants between January December 2021. Weight-for-age height-for-age z-scores (WAZ/HAZ) were calculated 12-weekly anthropometry over 96 weeks. Height trajectory analyses SuperImposition by Translation And Rotation (SITAR) methods adjusting for height, tempo (aPHV) velocity. Linear associations D/calcium supplementation, HIV-specific factors, WAZ, HAZ, SITAR parameters determined. Overall, 842 (53·2% female; median 15·5 [IQR:13·2-17·9] years), taking 9·8(IQR:6·3–12·3) years. Mean(SD) HAZ was 1·21(1·05) females, -1·68(1·05) males. 251(29·8%) stunted (HAZ < -2) 253(30%) wasted (WAZ -2). Standing, appendicular axial aPHVs were: Female 13·4, 13·3, 13·9 years; Males 15·3, 15·0, 15·8 Unsuppressed viral-load(VL) delayed initiation (age > 4-years) associated later aPHV shorter females. In all, unsuppressed VL had a more negative effect (Females: β = 0·39 years [95%CI:0·12,0·65]; Males: 0·45 [95%CI:0·10,0·80]) than growth 0.31 [95%CI 0·08,0·53]; 0·2 [95%CI:-0·17,0·56]). Conversely, negatively related 0·25 [95% CI:0·08,0·43]; 0·63 [95%CI:0·32, 0·93] 0·13 [95%CI:-0·08,0·34]; 0·56 [95%CI:0·28,0·86]. Lower WAZ lower PHV. At 48-week vitamin-D3/calcium no the pattern. viral load ART-initiation predicted aPHV. Stunting wasting attenuated experience persistent linear impairments, potentially persisting into adulthood. (PACTR20200989766029|| http://www.pactr.org/ ); First registered 03/09/2020.