Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand.

OBJECTIVE: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. DESIGN: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. METHODS: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. RESULTS: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. CONCLUSION: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age

Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand

Objective: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. Design: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. Methods: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. Results: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. Conclusion: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age

Time to Switch to Second-line Antiretroviral Therapy in Children With Human Immunodeficiency Virus in Europe and Thailand.

Background: Data on durability of first-line antiretroviral therapy (ART) in children with human immunodeficiency virus (HIV) are limited. We assessed time to switch to second-line therapy in 16 European countries and Thailand. Methods: Children aged <18 years initiating combination ART (≥2 nucleoside reverse transcriptase inhibitors [NRTIs] plus nonnucleoside reverse transcriptase inhibitor [NNRTI] or boosted protease inhibitor [PI]) were included. Switch to second-line was defined as (i) change across drug class (PI to NNRTI or vice versa) or within PI class plus change of ≥1 NRTI; (ii) change from single to dual PI; or (iii) addition of a new drug class. Cumulative incidence of switch was calculated with death and loss to follow-up as competing risks. Results: Of 3668 children included, median age at ART initiation was 6.1 (interquartile range (IQR), 1.7-10.5) years. Initial regimens were 32% PI based, 34% nevirapine (NVP) based, and 33% efavirenz based. Median duration of follow-up was 5.4 (IQR, 2.9-8.3) years. Cumulative incidence of switch at 5 years was 21% (95% confidence interval, 20%-23%), with significant regional variations. Median time to switch was 30 (IQR, 16-58) months; two-thirds of switches were related to treatment failure. In multivariable analysis, older age, severe immunosuppression and higher viral load (VL) at ART start, and NVP-based initial regimens were associated with increased risk of switch. Conclusions: One in 5 children switched to a second-line regimen by 5 years of ART, with two-thirds failure related. Advanced HIV, older age, and NVP-based regimens were associated with increased risk of switch

Etnografía : sus bases, sus métodos y aplicaciones a España

Serie tomada de cub. origSerie tomada da capa ori

Anales de Edafología y Agrobiología Tomo 43 Número 3-4

Suelos. Variación de la penetrabilidad en suelos del ·altiplano de Pasto, Colombia, por Luis Guevara, B.; Hernan Rojas, G. y Lucio Legarda, B.-- Adsorción de diazinon por montmorillonita. l.-Efecto del Catión de cambio, por G. Dios Cancela, S. González García y M. Martín Aguilar.—.Adsorción de diazinon por montmorillonita. H.-Efecto del pretratamiento térmico de las muestras, por S. González García, G. Dios Cancela y M. Martín Aguilar.-- Síntesis y caracterización de sustancias húmicas a partir de una novolaca y una resina hidroquinona-formaldehido. l.-Bases y síntesis, por Octavio Carpena Artes, Vicente Galvan Fernández y José Luis Valdés Fernández.-- Síntesis y caracterización de sustancias húmicas a partir de una novolaca y una resina hidroquinona-formaldehido. II. Caracterización, por Octavio Carpena Artes, Vicente Galuán López y José Luis Valdés Fernández.-- Influencia del factor antrópico en la evolución de los suelos desarrollados sobre cuarcitas en el clima xérico, por García Fernández, l. y Simón Torres, M.-- Estudio cinético de la actividad fosfatásica en unidades reales y estructurales de agregación del suelo, por Rojo Cámara, M. a J., Busto Núñez, Ma D. y González Carcedo, S.-- Optimización de un método para la determinación de la actividad asparraginásica en muestras de suelo, por García Melus, M. a C. y González, S.-- Modulación microbiana de la ureasa en suelos, por González Carcedo, S. y Fuente Marcos, M. A.-- Distribución de la actividad ureásica en las unidades de estructura del suelo. I. Efecto del fraccionamiento, por Pérez Mateos, M. y González Carcedo, S.-- Estudio genético de suelos del Puerto del Pon ton (León), por Hoyos de Castro, A.; Hernando Massanet, I.: Palomar Ga Villamil y M. L. Gómez Gomez, A.-- Caracterización y génesis de los suelos sobre esquistos de las Marinas (La Coruña), por B. M. Silua Hermo; E. García-Rodeja, Gayoso; F. Macias Vázquez.-- Estudio de ácidos húmicos de tipo P. Distribución de los pigmentos verdes en las diferentes fracciones húmicas del suelo, por Almendros, G. y Dorado, E.—Fertilidad del Suelo. Efecto de la Acidez del suelo sobre el crecimiento y nutrición del trebol violeta en el año siguiente al de la siembra, por J. Arines y R. Fábregas.-- Aplicación del análisis en componentes principales al estudio de las aguas de riego de la Vega Alta del Segura, por Bolarín, M. C.; Muñoz, F.; Romero, M. y Guillen, M. G.—Nutrición y Fisilogía Vegetal. Morfogénesis en secciones de plántulas de castaño cultivadas "in vitro" por San José, M. C. y Vieitez, E.-- Solubilización de los fosfatos BI y tricálcico por Bacillus Cereus. Ensayos "in vitro", por Fernández Herrera, M. Carpena Artes, O. y Cadahía López, C.-- Variación de la relación H/T en el trevol violeta, por Arines, J. Fábregas, R. y Sainz, M.O. Jesús.-- Análisis de la medida de la actividad nitrogenasa (Reducción de Acetileno) para la selección de razas efectivas de Rhizobium, por Eulogio J. Bedmar, Eustoquio Martínez-Molina y José Olivares.-- Dinámica, equilibrios o índices de .los macro y micronutrientes en plantas de Tilia Platypi)yllos Scop., por M. Guzmán y L. Romero.—Ecología. Micorrizas vesículo-arbusculares en praderas de Galicia, por Ma Jesús Sainz; R. Fábregas y J. Arines.—Trabajos recapitulativos. Avances recientes en el estudio de la micorrizas V-A. l.-Formación, funcionamiento y efectos en nutrición vegetal, por J. M. Barea, C. Azcón-Aguilar y B. Roldán-Fajardo.-- Notas.-- BibliografíaPeer reviewe

Children living with HIV in Europe: do migrants have worse treatment outcomes?

Objectives: To assess the effect of migrant status on treatment outcomes among children living with HIV in Europe. Methods: Children aged < 18 years at the start of antiretroviral therapy (ART) in European paediatric HIV observational cohorts where ≥ 5% of children were migrants (defined as born abroad) were included. Three outcomes were considered: (i) severe immunosuppression-for-age; (ii) viraemic viral load (≥ 400 copies/mL) at 1 year after ART initiation; and (iii) AIDS/death after ART initiation. The effect of migrant status was assessed using univariable and multivariable logistic and Cox models. Results: Of 2620 children included across 12 European countries, 56% were migrants. At ART initiation, migrant children were older than domestic-born children (median 6.1 vs. 0.9 years, p < 0.001), with slightly higher proportions being severely immunocompromised (35% vs. 33%) and with active tuberculosis (2% vs. 1%), but a lower proportion with an AIDS diagnosis (14% vs. 19%) (all p < 0.001). At 1 year after beginning ART, a lower proportion of migrant children were viraemic (18% vs. 24%) but there was no difference in multivariable analysis (p = 0.702), and no difference in severe immunosuppression (p = 0.409). However, there was a trend towards higher risk of AIDS/death in migrant children (adjusted hazard ratio = 1.51, 95% confidence interval: 0.96–2.38, p = 0.072). Conclusions: After adjusting for characteristics at ART initiation, migrant children have virological and immunological outcomes at 1 year of ART that are comparable to those who are domestic-born, possibly indicating equity in access to healthcare in Europe. However, there was some evidence of a difference in AIDS-free survival, which warrants further monitoring

Malignancies among children and young people with HIV in Western and Eastern Europe and Thailand the European Pregnancy and Paediatric Infections Cohort Collaboration (EPPICC) study group

Objectives: Investigate trends over time and predictors of malignancies among children and young people with HIV. Design: Pooled data from 17 cohorts in 15 countries across Europe and Thailand. Methods: Individuals diagnosed with HIV and presenting to paediatric care less than 18 years of age were included. Time at risk began at birth for children with documented vertically acquired HIV, and from first HIV-care visit for others. Children were followed until death, loss-to-follow-up, or last visit in paediatric or adult care (where data after transfer to adult care were available). Rates of reported malignancies were calculated overall and for AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (NADM) separately. Risk factors for any malignancy were explored using Poisson regression, and for mortality following a malignancy diagnosis using Cox regression. Results: Among 9632 individuals included, 140 (1.5%) were ever diagnosed with a malignancy, of which 112 (80%) were ADM. Overall, the rate of any malignancy was 1.18 per 1000 person-years; the rate of ADM decreased over time whereas the rate of NADM increased. Male sex, being from a European cohort, vertically acquired HIV, current severe immunosuppression, current viral load greater than 400 copies/ml, older age, and, for those not on treatment, earlier calendar year, were risk factors for a malignancy diagnosis. Fifty-eight (41%) individuals with a malignancy died, a median 2.4 months (IQR 0.6-8.8) after malignancy diagnosis. Conclusion: The rate of ADM has declined since widespread availability of combination ART, although of NADM, there was a small increase. Mortality following a malignancy was high, warranting further investigation