| Titre : | Effects of the initiation of Dolutegravir-based ART regimens on growth indicators among children and adolescents living with HIV. Insights from the IeDEA global cohort. |
| Auteurs : | Juan David Medina Cruz ; Ecole des hautes études en santé publique (EHESP) (Rennes, FRA) |
| Type de document : | Mémoire |
| Année de publication : | 2025 |
| Description : | 64p. |
| Langues: | Anglais |
| Classement : | MPH/ (Mémoires MPH à partir de 2024) |
| Mots-clés : | Sida ; Enfant ; Adolescent ; Courbe croissance ; Prise poids ; Thérapeutique |
| Résumé : |
Background: Global guidelines now prioritize early and universal ART initiation in children and adolescents living with HIV (CALHIV) with dolutegravir (DTG)-based regimens, due to their efficacy, safety, and child-friendly formulations. However, emerging evidence suggests that DTG, especially when used with tenofovir alafenamide (TAF), may be associated with excess weight gain and potential metabolic disturbances in older populations, underscoring the need for careful regimen selection amongst CALHIV and long-term monitoring.
Aim: This study aims to assess growth trajectories among CALHIV following initiation or switch to DTG-based ART, using data from the global IeDEA pediatric cohort. Specifically, it examines changes in BMI-for-age z-scores (zBMI). Methods: The analysis includes CALHIV aged >30 days to < 0.001). DTG+TAF regimens were associated with the greatest initial zBMI increase (0.30 95% CI: 0.18 to 0.49) (p = 0,319), which then declined in the second year (-0.08 IC 95% : -0.32 to 0.16). Results: A total of 29,663 children and adolescents living with HIV were included in analyses. The cohort counted with 13,671 males (46.1%) and 15,992 females (53.9%). At the time of DTG start, the median age was 12.9 years (interquartile range [IQR]: 9.2–15.9). The Southern Africa region contributed the largest proportion of participants (50%), followed by East Africa (33%), West Africa (7%), and Central Africa (5%). The median baseline zBMI was –0.62 (IQR: –1.47 to 0.16) and was significantly lower among males compared to females (−0.84 vs. −0.45, p< 0.001). DTG+TAF regimens were associated with the greatest initial zBMI increase (0.30 95% CI: 0.18 to 0.49) (p = 0,319), which then declined in the second year (-0.08 IC 95% : -0.32 to 0.16). |
| Diplôme : | Master MPH of public health |
| Plan de classement simplifié : | Master of Public Health - master international de Santé Publique (MPH) |
| En ligne : | https://documentation.ehesp.fr/memoires/2025/mph/juan_david_medina_cruz.pdf |
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