Growth Outcomes After 48 Weeks of Dolutegravir in Children and Adolescents with HIV-1 in IMPAACT P1093 and IMPAACT 2019

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ID: 328369
2026
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Abstract
BACKGROUND: We evaluated growth outcomes in children and adolescents with HIV-1 initiating or switching to dolutegravir-based antiretroviral therapy (ART) in the single-arm trials IMPAACT P1093 (P1093) and IMPAACT 2019. METHODS: We performed descriptive post hoc analyses of body mass index-for-age (BAZ), weight-for-age (WAZ), and length/height-for-age z scores (L/HAZ) for each trial through Week 48. BAZ changes were assessed using a mixed model for repeated measures. RESULTS: We included data from 181 and 57 participants from P1093 and IMPAACT 2019, respectively (10% [23/238] were adolescents). Baseline mean BAZ was -0.1 in P1093 and - 0.7 in IMPAACT 2019. At Week 48, adjusted mean BAZ increased significantly in P1093 (0.3; 95% CI, 0.03, 0.49; p < 0.05) and non-significantly in IMPAACT 2019 (0.3; 95% CI, -0.03, 0.58; p = 0.074). Mean BAZ was in the normal range at Week 48 in both trials. Marked increases in BAZ were observed among subgroups with baseline BAZ < -2. By Week 48, 65% (117/181) of participants in P1093 and 74% (42/57) in IMPAACT 2019 remained in the same BAZ category. Improvements from severe or moderate malnutrition/thinness to normal weight occurred in 6% (10/181) and 7% (4/57) of participants in P1093 and IMPAACT 2019, respectively, while increases to overweight or obesity were observed in 9% (16/181) and 5% (3/57). Small changes were observed in overall mean WAZ and L/HAZ through Week 48 in both trials. CONCLUSIONS: Small overall increases in BAZ were observed over 1 year among pediatric participants on dolutegravir-based ART, with most participants remaining in their baseline BAZ category. CLINICAL TRIAL INFORMATION: ClinicalTrials.gov, NCT01302847 and NCT03760458.
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openalex_W7212394579 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Michael McKenna, Zrinka Lulic, Ann M. Buchanan, Cynthia Brothers, Lionel Tan, Marcia Wang, Sean Brummel, Lauren Ziemba, Theodore Ruel, Patricia M. Flynn, Helena Rabie, Andrew Wiznia
Journal journal of the pediatric infectious diseases society
Year 2026
DOI
10.1093/jpids/piag088
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