Clinical and immunological characteristics of failure to thrive (FTT) in perinatally-HIV (P-HIV) infected children
Objective;To examine the immunologie and clinical characteristics of P-HIV children who fail to thrive and compare those characteristics to a cohort of P-HIV children with normal growth Methods: Analysis of 165 children born to HIV-infected mothers was conducted over a 19 month period assessing the following variables: age. sex. weight height serum albumin, CDC immunologie staging, use of anti-retrovirals, presence of a consistent primary caretaker, and Variables FTT n=16 Control n=61 P Mean age 5.9 yrs 5.7 yrs NS Sex % male 56.3% 47.7% NS CDC Immune Stage I or 2 37.4% 63.4% Stage3 62.5% 36.5% NS Antiretrovirals % yes 81.3% 71.4% NS Consistent caretaker 1° 81.2% 96.7% <.05 Developmental delay 62.5% 32.5% 0.05 development FIT was defined as weight & height < 5th% for age and a consistent primary caretaker was defined as an adutt figure providing > 90% of the patient's care. Results: P-HIV infection was diagnosed in 89 children in this cohort FIT occurred in 16 (18.0%) of 89 P-HIV children. Among seroreverters FIT occurred in only 4 children (5.3%; P<0.01 ). Clinical and immunologie characteristics of P-HIV children with FIT and of P-HIV children with normal growth is shown in the table. Only I child in each group was hypoalbuminemic (<3.0 gm%). Conclusions: FIT is more frequent in P-HIV infected children than in non-infected children born to HIV-infected mothers. Greater immunologie deficiency may be associated with FTT in P-HIV infants although differences between FTT and infants with normal growth were not statistically significant The mufti-factorial etiology of FTT in P-HIV infants is underscored by the observation that lack of a consistent caretaker and developmental delay are significantly greater in P-HIV children who fail to thrive when compared to P-HIV children with normal growth.