Body Mass Index Trends in Children and Adolescents on Antiretroviral Therapy in Nigeria: A Prospective Evaluation of Regimen-Specific Effects

Children and adolescents livingwith HIV (CALHIV) on antiretroviral therapy (ART) are susceptible to metabolic changes as they develop into adulthood, including significant variations in body mass index (BMI). This study evaluates the relationship between ART regimens and BMI trends in a cohort of paediatric population, exploring demographic influences and regimen-specific outcomes. This prospective observational study analyzed BMI trends in 147 children and adolescent living with HIV (CALHIV) (aged 2-16 years) on various ART regimens across three clinic visits. Participants were grouped into six ART regimen categories, including DTG-and LPV/r-based therapies. BMI (calculated from weight and height), CD4 counts, and viral load data were collected and analyzed to assess changes over time in each clinic visit. The data obtained were analyzed using SPSS version 20, with descriptive statistics and BMI changes assessed across visits; significance was set at p < 0.05. The mean participant age was 10.87±3.64 years, with most (95) aged ≥10 years and a male predominance (85 males, 62 females). BMI increased across all groups, with the TLD regimen showing the highest increase (22.99±3.45, 24.94±4.20, 26.79±4.97; p<0.05). BMI increases were progressive across the 3 visitsin the TLD group with a consistent >85thpercentile CDC BMI category. Adolescents (mean age: 13 years) had higher BMI, while gender had no significant impact (p=0.48). Despite BMI increases, CD4+ counts remained stable, and viral load was notably higher in ALD and ALE groups, though not statistically significant (p>0.05). Dolutegravir-based ART regimens, particularly TLD, are linked to significant BMI increases while maintaining virological while maintaining immunological stability, with variable viral load outcomes. Routine metabolic monitoring and targeted interventions are essential, especially for adolescents. Future studies should explore long-term metabolic outcomes and ART optimization in pediatric populations