Long-term follow-up of children in the HIVNET 012 perinatal HIV prevention trial: Five-year growth and survival

Maxensia Owor, Anthony Mwatha, Deborah Donnell, Philippa Musoke, Francis Mmiro, Melissa Allen, J. Brooks Jackson, Mary Glenn Fowler, Laura A. Guay

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

OBJECTIVES: To describe 5-year growth, survival, and long-term safety among children exposed to nevirapine or zidovudine in an African perinatal prevention trial, HIVNET 012. METHODS: All study children who were alive at the age 18 months were eligible for an extended follow-up study. Children whose families consented were enrolled and evaluated every 6 months from 24 to 60 months. At each visit, history, physical examination, and growth measures were taken. From these measurements, Z scores based on World Health Organization (WHO) standards were computed. Serious adverse event data were collected. Data from the initial and extended follow-up cohorts were included in the analysis. RESULTS: Five hundred twenty-eight study children were alive at the age 18 months, and 491 (426 HIV uninfected and 65 infected) were enrolled into the follow-up study. Both exposed but uninfected children and HIV-infected children were substantially below WHO growth standards for weight and height. Head circumference Z scores for uninfected children were comparable with WHO norms. Five-year survival rates were 93% for uninfected children versus 43% for infected children. Long-term safety and growth outcomes in the 2 study arms were similar. CONCLUSIONS: Both infected and uninfected children in the 5-year HIVNET 012 follow-up showed poor height and weight growth outcomes, underscoring the need for early nutritional interventions to improve long-term growth of all infants born to HIV-infected women in resource-limited settings. Similarly, the low 5-year survival among HIV-infected children support the importance of early initiation of antiretroviral therapy. Both peripartum nevirapine and zidovudine were safe.

Original languageEnglish (US)
Pages (from-to)464-471
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume64
Issue number5
DOIs
StatePublished - Dec 15 2013

Keywords

  • HIVNET 012
  • children
  • long-term follow-up
  • perinatal HIV prevention trial

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    Owor, M., Mwatha, A., Donnell, D., Musoke, P., Mmiro, F., Allen, M., Jackson, J. B., Fowler, M. G., & Guay, L. A. (2013). Long-term follow-up of children in the HIVNET 012 perinatal HIV prevention trial: Five-year growth and survival. Journal of Acquired Immune Deficiency Syndromes, 64(5), 464-471. https://doi.org/10.1097/QAI.0000000000000015