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&#40;i&#41; intra&#250;tero por via transplacent&#225;ria&#59; &#40;ii&#41; durante o parto e&#47;ou nascimento&#59; e &#40;iii&#41; a partir do aleitamento materno&#46; A maior parte dos casos &#40;65&#37;&#41; ocorre durante o trabalho de parto e no parto propriamente dito&#44; os 35&#37; restantes no intrauterino&#44; principalmente nas &#250;ltimas semanas de gesta&#231;&#227;o e quando do aleitamento materno&#46; O aleitamento materno&#44; como risco de transmiss&#227;o&#44; &#233; respons&#225;vel por 7&#37; a 22&#37; dos casos de infec&#231;&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Dados mundiais de 2016 estimam que 36&#44;7 &#91;30&#44;8&#8211;42&#44;9&#93; milh&#245;es de pessoas&#44; dessas 2&#44;1 milh&#245;es crian&#231;as&#44; estejam infectadas pelo HIV&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">2</span></a> No Brasil&#44; de 1980 a 2016&#44; foram identificados 842&#46;710 casos de infec&#231;&#227;o pelo HIV&#44; aproximadamente 24&#46;900 crian&#231;as estavam abaixo de 14 anos &#8211; n&#250;mero possivelmente subestimado&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Indiv&#237;duos infectados pelo HIV t&#234;m redu&#231;&#227;o no n&#250;mero de LT CD4<span class="elsevierStyleSup">&#43;</span> &#8211; caracter&#237;stica marcante do quadro imunol&#243;gico&#46; O mecanismo que causa a falha em reconstituir os LT CD4<span class="elsevierStyleSup">&#43;</span> n&#227;o &#233; totalmente elucidado&#44; por&#233;m aumenta o risco de infec&#231;&#245;es oportunistas&#46; Al&#233;m das altera&#231;&#245;es imunol&#243;gicas&#44; existem problemas nutricionais e end&#243;crino&#8208;metab&#243;licos na AIDS&#44; a infec&#231;&#227;o pelo HIV &#233; associada ao comprometimento no crescimento&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">5</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Defici&#234;ncia de crescimento na AIDS</span><p id="par0020" class="elsevierStylePara elsevierViewall">Nas crian&#231;as e adolescentes com HIV existe maior preval&#234;ncia de dist&#250;rbios do crescimento&#44; que incluem desde a dificuldade para crescer &#8211; que resulta em peso e estatura inferiores ao padr&#227;o normal para idade &#8211;&#44; interrup&#231;&#227;o do crescimento e s&#237;ndrome de emaciamento&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">6</span></a> O atraso no crescimento &#233; indicador de progress&#227;o de gravidade e fator de risco para o &#243;bito na AIDS&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">7</span></a> Al&#233;m disso&#44; na AIDS&#44; a defici&#234;ncia de crescimento &#233; multifatorial&#44; &#233; decorrente do efeito da terapia antirretroviral&#44; bem como de outros fatores&#44; descritos a seguir&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#40;i&#41;</span><p id="par0025" class="elsevierStylePara elsevierViewall">desnutri&#231;&#227;o&#58; pode ocorrer principalmente pelo aporte nutricional inadequado&#44; secund&#225;rio &#224; anorexia&#44; les&#245;es orais ou do trato digestivo alto &#40;causa infecciosa&#41;&#44; redu&#231;&#227;o de ingest&#227;o &#40;causa psicol&#243;gica ou econ&#244;mica&#41; ou ainda por m&#225; absor&#231;&#227;o de nutrientes &#40;diarreia cr&#244;nica&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">8</span></a> Outro aspecto importante refere&#8208;se &#224; acelera&#231;&#227;o do catabolismo proteico e aumento do gasto metab&#243;lico&#44; secund&#225;rios &#224; replica&#231;&#227;o viral n&#227;o controlada e &#224; resposta inflamat&#243;ria dela decorrente &#40;inclusive desregula&#231;&#227;o da rede de citocinas&#41;&#44; bem como infec&#231;&#245;es oportunistas ou neoplasias secund&#225;rias &#224; imunossupress&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">2</span></a> A desnutri&#231;&#227;o associada ao HIV foi denominada <span class="elsevierStyleItalic">wasting syndrome</span> ou s&#237;ndrome de emaciamento&#59;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">9</span></a></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#40;ii&#41;</span><p id="par0030" class="elsevierStylePara elsevierViewall">dist&#250;rbios gastrintestinais &#40;m&#225; absor&#231;&#227;o&#41;&#58; podem resultar da infec&#231;&#227;o pelo pr&#243;prio HIV&#44; infec&#231;&#245;es oportunistas &#40;parasitas ent&#233;ricos&#44; como <span class="elsevierStyleItalic">Cryptosporidium</span>&#44; <span class="elsevierStyleItalic">Mycobacterium avium&#8208;intracellulare</span>&#44; citomegalov&#237;rus&#44; dentre outros&#41; ou neoplasias&#46; Diarreia&#44; dor abdominal e disfagia s&#227;o comumente observados em pacientes infectados pelo HIV&#46; No entanto&#44; a m&#225; absor&#231;&#227;o intestinal pode ocorrer em crian&#231;as&#44; com ou sem diarreia&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">10</span></a> A les&#227;o da integridade da mucosa e o aumento da permeabilidade favorecem a disfun&#231;&#227;o intestinal&#44; levam &#224; m&#225; absor&#231;&#227;o de gorduras&#44; carboidratos e prote&#237;nas&#44; interfere no ganho p&#244;ndero&#8208;estatural&#46; A disfun&#231;&#227;o intestinal pode interferir adversamente na habilidade de absorver medica&#231;&#245;es orais&#44; inclusive a zidovudina &#40;AZT&#44; C<span class="elsevierStyleInf">10</span>H<span class="elsevierStyleInf">13</span>N<span class="elsevierStyleInf">5</span>O<span class="elsevierStyleInf">4</span>&#41;&#59;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">11</span></a></p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#40;iii&#41;</span><p id="par0035" class="elsevierStylePara elsevierViewall">estresse&#58; na AIDS&#44; a express&#227;o das citocinas&#44; inclusive interleucinas &#40;1 e 6&#41;&#44; fator de necrose tumoral alpha e interferon est&#227;o alterados&#44; promovem um estresse metab&#243;lico&#44; podem ocasionar perda de apetite&#44; anorexia e catabolismo&#59;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">9</span></a></p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#40;iv&#41;</span><p id="par0040" class="elsevierStylePara elsevierViewall">doen&#231;a cr&#244;nica&#58; a infec&#231;&#227;o pelo HIV acarreta a redu&#231;&#227;o progressiva da fun&#231;&#227;o imune&#44; com diminui&#231;&#227;o no n&#250;mero de LT CD4<span class="elsevierStyleSup">&#43;</span>&#44; concomitantemente &#224;s altera&#231;&#245;es na fun&#231;&#227;o dessas c&#233;lulas e das principais vias regulat&#243;rias da imunidade&#46; Assim&#44; a susceptibilidade &#224; infec&#231;&#227;o de repeti&#231;&#227;o e defici&#234;ncias de anticorpos alteram o metabolismo por infec&#231;&#227;o e&#47;ou redu&#231;&#227;o de ingest&#227;o&#44; &#233; necess&#225;rio acompanhamento nutricional dos pacientes&#59;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">8</span></a></p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#40;v&#41;</span><p id="par0045" class="elsevierStylePara elsevierViewall">dist&#250;rbios end&#243;crinos&#58; as altera&#231;&#245;es hormonais s&#227;o&#44; provavelmente&#44; causadas pela pr&#243;pria infec&#231;&#227;o viral ou secund&#225;rias ao comprometimento das gl&#226;ndulas end&#243;crinas&#44; por infec&#231;&#245;es oportunistas e&#47;ou medicamentos usados no tratamento das infec&#231;&#245;es e&#47;ou suas complica&#231;&#245;es&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">12</span></a></p></li></ul></p><p id="par0050" class="elsevierStylePara elsevierViewall">Nesse sentido&#44; se destaca a import&#226;ncia da associa&#231;&#227;o de fatores&#44; para o d&#233;ficit de crescimento&#44; o que refor&#231;a a necessidade de ampliar a compreens&#227;o em rela&#231;&#227;o a eles&#44; no intuito de minimizar os preju&#237;zos no estado nutricional&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">11</span></a> O monitoramento adequado pela equipe multidisciplinar contribui para detec&#231;&#227;o precoce de infec&#231;&#245;es oportunistas&#44; altera&#231;&#245;es metab&#243;licas e hormonais&#44; diminui&#231;&#227;o da ingest&#227;o alimentar&#44; m&#225; absor&#231;&#227;o de nutrientes e problemas socioecon&#244;micos&#44; resulta&#44; provavelmente&#44; em benef&#237;cios ao ganho p&#244;ndero&#8208;estatural&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">12</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Terapia antirretroviral &#8211; Aspectos gerais</span><p id="par0055" class="elsevierStylePara elsevierViewall">A d&#233;cada de 1990 foi um marco para o tratamento da AIDS&#44; com o uso de esquemas antirretrovirais mais efetivos &#8211; terapia antirretroviral altamente ativa&#46; Inicialmente&#44; a terapia antirretroviral era baseada na monoterapia com AZT&#44; por&#233;m havia baixa efic&#225;cia&#44; com necessidade de progressiva associa&#231;&#227;o de medicamentos&#46; Posteriormente&#44; foi institu&#237;da a terapia dupla&#44; com o uso de novos inibidores de transcriptase reversa an&#225;logos de nucleos&#237;deos&#46; Em seguida&#44; surgiram os inibidores de protease e inibidores de transcriptase reversa n&#227;o an&#225;logos de nucleos&#237;deos &#8211; esquema terap&#234;utico com tr&#234;s medicamentos e denominado terapia antirretroviral combinada &#40;TARVc&#41;&#46; A TARVc reduziu a mortalidade por HIV&#44; principalmente&#44; em pa&#237;ses desenvolvidos&#46;<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">6&#44;13</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Desde 1996&#44; a TARVc &#233; usada na inf&#226;ncia&#44; para minimizar a progress&#227;o da doen&#231;a&#46; Estima&#8208;se que sem o uso da terapia antirretroviral um ter&#231;o das crian&#231;as infectadas pelo HIV faleceria antes de um m&#234;s de idade e mais da metade antes dos dois anos&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">14</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Terapia antirretroviral &#8211; Associa&#231;&#227;o com dados antropom&#233;tricos e outros</span><p id="par0065" class="elsevierStylePara elsevierViewall">A terapia antirretroviral&#44; na inf&#226;ncia e na adolesc&#234;ncia&#44; pode causar desordens metab&#243;licas&#44; toxicidade mitocondrial e efeitos adversos no estado nutricional&#44; principalmente nos primeiros meses de tratamento&#46; Os pacientes podem evoluir com n&#225;useas ou v&#244;mitos&#44; lipodistrofia e redu&#231;&#227;o da mineraliza&#231;&#227;o &#243;ssea&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">2</span></a> O diagn&#243;stico e tratamento da desnutri&#231;&#227;o &#233; necess&#225;rio&#44; uma vez que a defici&#234;ncia de micronutrientes&#44; principalmente vitaminas A&#44; C&#44; E&#44; D e minerais &#40;por exemplo&#44; sel&#234;nio e ferro&#41;&#44; altera o sistema imunol&#243;gico &#40;j&#225; alterado na AIDS&#41; e reduz o crescimento&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">2</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Em adultos&#44; a dura&#231;&#227;o da TARVc aumenta o risco de doen&#231;as cardiovasculares &#40;acidente vascular cerebral&#44; infarto e miocardiopatia dilatada&#41;&#46; Dessa forma&#44; se sugere que as crian&#231;as em uso dos antirretrovirais provavelmente ter&#227;o maior risco de morbidade e mortalidade cardiovascular prematura&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">3</span></a> Al&#233;m disso&#44; a ativa&#231;&#227;o imune&#44; com inflama&#231;&#227;o cr&#244;nica persistente em indiv&#237;duos infectados pelo HIV&#44; tamb&#233;m aumenta o risco de doen&#231;a cardiovascular e outras doen&#231;as de origem inflamat&#243;ria&#46; N&#237;veis aumentados de marcadores inflamat&#243;rios &#40;prote&#237;na C reativa&#44; interleucina 6&#44; D&#8208;d&#237;mero&#44; fibrinog&#234;nio&#41;&#44; associados ao risco de aterosclerose e c&#226;ncer&#44; por exemplo&#44; tamb&#233;m s&#227;o encontrados na AIDS e se mant&#234;m elevados independentemente da resposta a TARVc&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">15</span></a> Finalmente&#44; a ades&#227;o ao tratamento&#44; o que inclui o uso do TARVc&#44; constitui um desafio&#44; principalmente na inf&#226;ncia e na adolesc&#234;ncia&#44; devido ao uso cr&#244;nico do medicamento&#44; altera&#231;&#245;es est&#233;ticas relacionadas &#224; lipodistrofia e aspectos psicossociais&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">16</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">O crescimento&#44; na inf&#226;ncia e na adolesc&#234;ncia&#44; &#233; crucial e na AIDS o impacto positivo e negativo da TARVc deve ser avaliado&#46; Dessa forma&#44; o objetivo da revis&#227;o sistem&#225;tica foi avaliar a rela&#231;&#227;o entre terapia antirretroviral e o crescimento de crian&#231;as e adolescentes infectados pelo HIV&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">M&#233;todo</span><p id="par0080" class="elsevierStylePara elsevierViewall">Foi feita uma revis&#227;o sistem&#225;tica&#44; que teve como crit&#233;rio de elegibilidade a estrat&#233;gia PRISMA &#40;<span class="elsevierStyleItalic">preferred reporting items for systematic reviews and meta&#8208;analyses</span>&#41;&#46; Dentro da estrat&#233;gia PRISMA&#44; o PICO &#40;<span class="elsevierStyleItalic">population</span>&#44; <span class="elsevierStyleItalic">intervention</span>&#44; <span class="elsevierStyleItalic">comparison&#47;control</span>&#44; <span class="elsevierStyleItalic">outcome</span>&#41; foi empregado na constru&#231;&#227;o do objetivo do estudo&#58; P&#44; crian&#231;as e adolescentes de 0 a 19 anos&#59; I&#44; indiv&#237;duos em uso de TARVc&#59; C&#44; crescimento infantil&#59; O&#44; altera&#231;&#227;o no padr&#227;o de crescimento&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">No PRISMA&#44; foi selecionado o per&#237;odo de inclus&#227;o de estudos de 1996 &#40;ano de in&#237;cio da TARVc&#41; a setembro de 2017&#46; Foram inclu&#237;dos artigos originais publicados em peri&#243;dicos indexados em l&#237;ngua inglesa&#46; Optou&#8208;se pela inclus&#227;o de todo o tipo de estudo e entre os artigos selecionados foi feita a classifica&#231;&#227;o por grau de recomenda&#231;&#227;o e n&#237;vel de evid&#234;ncia&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">As buscas foram feitas nas bases de dados Medline&#8208;PubMed &#40;<span class="elsevierStyleItalic">Medical Literature Analysis and Retrieval System Online &#8211; Public Medline</span>&#41; e Lilacs &#40;Literatura Latino&#8208;Americana e do Caribe em Ci&#234;ncias da Sa&#250;de&#41;&#44; pelos descritores&#58; <span class="elsevierStyleItalic">antiretroviral therapy</span>&#44; <span class="elsevierStyleItalic">children</span>&#44; <span class="elsevierStyleItalic">growth</span>&#44; HIV&#46; Como filtros foram usados&#58; &#40;i&#41; presen&#231;a dos descritores no t&#237;tulo e&#47;ou resumo&#59; &#40;ii&#41; publica&#231;&#245;es nos &#250;ltimos 21 anos&#59; &#40;iii&#41; ser artigo cient&#237;fico&#46; Foram exclu&#237;dos artigos&#58; &#40;i&#41; que se repetiram em outra base de dados eletr&#244;nica da busca bibliogr&#225;fica&#59; &#40;ii&#41; sobre o custo do tratamento da AIDS&#44; sem abordar o fator crescimento&#59; &#40;iii&#41; com crian&#231;as expostas ao HIV&#44; mas n&#227;o infectadas&#59; &#40;iii&#41; sobre crescimento perinatal&#59; &#40;iv&#41; sobre TARVc na gestante&#59; &#40;v&#41; com uso exclusivo de uma ou duas drogas antirretrovirais&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Na revis&#227;o bibliogr&#225;fica&#44; foram identificados 549 artigos&#44; dos quais foram selecionados pelo t&#237;tulo 98 no Medline&#8208;PubMed e 63 no Lilacs&#46; Na segunda avalia&#231;&#227;o&#44; feita pela leitura do resumo e pela exclus&#227;o dos artigos repetidos &#40;63&#41;&#44; foram inclu&#237;dos 92 artigos &#8211; lidos na &#237;ntegra&#46; Ap&#243;s a leitura na &#237;ntegra&#44; 44 estudos foram inclu&#237;dos na revis&#227;o sistem&#225;tica &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; Os artigos selecionados foram classificados por tr&#234;s autores &#40;dois m&#233;dicos e um nutricionista&#41;&#44; contemplaram os principais itens dos m&#233;todos e dos resultados de cada estudo selecionado &#40;autor&#44; ano&#44; pa&#237;s de origem do estudo&#44; tamanho da amostra&#44; resultados principais&#41;&#46; Todos os artigos foram avaliados e lidos por pelo menos tr&#234;s autores&#44; a leitura na &#237;ntegra foi feita por sorteio entre os autores&#46; A partir da conson&#226;ncia dos dados&#44; esses foram dispostos nas <a class="elsevierStyleCrossRefs" href="#tbl0005">tabelas 1 e 2</a>&#46;<a class="elsevierStyleCrossRefs" href="#bib0375"><span class="elsevierStyleSup">17&#8211;57</span></a> Foram inclu&#237;das interven&#231;&#245;es terap&#234;uticas feitas com pelo menos tr&#234;s drogas com a&#231;&#227;o antirretroviral&#44; sem considerar o tipo de TARVc&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><p id="par0100" class="elsevierStylePara elsevierViewall">Os dados obtidos est&#227;o sintetizados nas <a class="elsevierStyleCrossRefs" href="#tbl0005">tabelas 1 e 2</a>&#46; Na somat&#243;ria dos estudos avaliados&#44; houve a inclus&#227;o de uma popula&#231;&#227;o de 51&#46;992 indiv&#237;duos infectados por HIV&#46; Nos estudos&#44; a resposta positiva a TARVc&#44; com melhoria do crescimento&#44; foi observada em 34 artigos&#46; No entanto&#44; a melhoria do ganho p&#244;ndero&#8208;estatural &#40;peso e estatura&#41;&#44; ao mesmo tempo&#44; ocorreu em 33 estudos&#46; Na maioria dos estudos foi ressaltada a import&#226;ncia do diagn&#243;stico precoce da infec&#231;&#227;o pelo HIV&#44; em crian&#231;as e adolescentes&#44; com intuito de protelar a progress&#227;o para AIDS e fazer o uso&#44; mais precoce poss&#237;vel&#44; da TARVc&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">A TARVc&#44; na literatura&#44; &#233; associada a melhoria dos &#237;ndices antropom&#233;tricos e da sobrevida&#46; Na revis&#227;o&#44; foi observado que 42&#46;203&#47;51&#46;992 &#40;81&#44;17&#37;&#41; crian&#231;as apresentaram melhoria no padr&#227;o de crescimento com o uso da TARVc&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Dos artigos inclu&#237;dos na revis&#227;o&#44; 42 t&#234;m grau de recomenda&#231;&#227;o B &#91;&#40;i&#41; um com n&#237;vel de evid&#234;ncia 2&#170;&#93;&#59; &#40;ii&#41; 35 com n&#237;vel de evid&#234;ncia 2B&#59; &#40;iii&#41; seis com n&#237;vel de evid&#234;ncia 2C e dois com n&#237;vel de evid&#234;ncia 1B &#40;grau de recomenda&#231;&#227;o A&#41;&#46; A classifica&#231;&#227;o dos artigos para n&#237;vel de evid&#234;ncia foi feita segundo recomenda&#231;&#245;es da <span class="elsevierStyleItalic">Oxford Centre for Evidence&#8208;based Medicine</span>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Na <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#44; apresentamos resumidamente os desfechos associados ao crescimento relacionado ao uso da TARVc&#44; em crian&#231;as e adolescentes&#44; infectados pelo HIV&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discuss&#227;o</span><p id="par0120" class="elsevierStylePara elsevierViewall">Altera&#231;&#245;es no crescimento s&#227;o comuns em crian&#231;as infectadas pelo HIV&#46;<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">58</span></a> Os dist&#250;rbios de crescimento podem estar associados a&#58; &#40;i&#41; infec&#231;&#245;es oportunistas associadas &#224; doen&#231;a&#59; &#40;ii&#41; aus&#234;ncia de controle imunol&#243;gico e viral no acompanhamento&#59; &#40;iii&#41; altera&#231;&#245;es metab&#243;licas associadas ao HIV&#46;<a class="elsevierStyleCrossRef" href="#bib0540"><span class="elsevierStyleSup">50</span></a> Entretanto&#44; ap&#243;s o in&#237;cio da TARVc&#44; mudan&#231;as no padr&#227;o de crescimento t&#234;m sido usadas como par&#226;metros de efetividade no tratamento de crian&#231;as e adolescentes com HIV&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">A partir dessa revis&#227;o feita nos &#250;ltimos 21 anos&#44; observou&#8208;se que a maioria dos estudos demonstrou associa&#231;&#227;o positiva no escore z&#8208;escore de altura&#8208;idade e de peso&#8208;idade com o uso da TARVc &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Al&#233;m das melhorias referentes &#224; antropometria&#44; a literatura demonstra que a TARVc tem apresentado quedas nos n&#237;veis de morbidade&#44; mortalidade e hospitaliza&#231;&#245;es dos pacientes infectados com HIV&#46; O tratamento com TARVc eleva a contagem de LT CD4<span class="elsevierStyleSup">&#43;</span>&#44; reduz a replica&#231;&#227;o viral e restaura parcialmente o sistema imunol&#243;gico&#46; Como resultado&#44; reduz a incid&#234;ncia de infec&#231;&#245;es oportunistas&#46;<a class="elsevierStyleCrossRefs" href="#bib0560"><span class="elsevierStyleSup">54&#44;58</span></a> Benjamin et al&#46; &#40;2003&#41; apresentaram que crian&#231;as em uso de TARVc tinham menos altera&#231;&#245;es no sistema imunol&#243;gico&#44; melhor resposta ao v&#237;rus e melhor curva de z&#8208;escore altura&#8208;idade&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">4</span></a> Verweel et al&#46; &#40;2002&#41; mostraram quedas de 63&#44;69&#37; nas interna&#231;&#245;es ap&#243;s a introdu&#231;&#227;o da TARVc&#46;<a class="elsevierStyleCrossRef" href="#bib0560"><span class="elsevierStyleSup">54</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">A literatura sugere que crian&#231;as que foram tratadas com monoterapia ou terapia dupla mostravam melhoria tempor&#225;ria do ritmo de crescimento&#46; No entanto&#44; que a TARVc resulta em aumento duradouro do peso e altura das crian&#231;as infectadas&#46; Esse aumento&#44; no entanto&#44; n&#227;o chegou a alcan&#231;ar os valores normais aos da popula&#231;&#227;o geral&#46; Buonora et al&#46; &#40;2008&#41; demonstraram que&#44; mesmo com a TARVc&#44; os pacientes infectados tinham par&#226;metros de crescimento inferiores aos da popula&#231;&#227;o n&#227;o infectada por HIV&#46;<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">41</span></a> Outro estudo avaliou que ap&#243;s introdu&#231;&#227;o da TARVc&#44; o z&#8208;escore peso&#8208;idade&#44; foi pr&#243;ximo ao da popula&#231;&#227;o sem infec&#231;&#227;o pelo HIV&#44; independentemente do tempo de in&#237;cio do tratamento&#46; Em contrapartida&#44; o z&#8208;escore altura&#8208;idade permaneceu baixo&#46;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">26</span></a> O mesmo foi observado na Europa&#44; onde&#44; ap&#243;s comparar curvas de crescimento de crian&#231;as infectadas e n&#227;o infectadas durante dez anos&#44; concluiu&#8208;se que a infec&#231;&#227;o pelo HIV causa crescimento mais lento e que as diferen&#231;as aumentam com a idade&#46;<a class="elsevierStyleCrossRef" href="#bib0555"><span class="elsevierStyleSup">53</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">Crian&#231;as mais jovens podem apresentar maior recupera&#231;&#227;o de peso e altura ap&#243;s o in&#237;cio da TARVc&#46; Nachman et al&#46; &#40;2005&#41;&#160;relatam que crian&#231;as menores de dois anos apresentaram maior z&#8208;escore de altura durante a terapia&#46;<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">49</span></a> O ganho de peso tamb&#233;m foi&#44; predominantemente&#44; maior em pacientes de menor idade&#46;<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">49</span></a> Shiau et al&#46; &#40;2013&#41; avaliaram quatro anos de seguimento de 195 pacientes com AIDS e demonstraram que pacientes que iniciaram a TARVc com menos de seis meses de vida apresentaram melhoria mais r&#225;pida no z&#8208;escore peso&#8208;idade e altura&#8208;idade do que aqueles que iniciaram depois&#46;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">26</span></a> Dessa forma&#44; quanto mais precoce a TARVc for iniciada&#44; menor ser&#225; a defici&#234;ncia de crescimento&#46;<a class="elsevierStyleCrossRefs" href="#bib0420"><span class="elsevierStyleSup">26&#44;37</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Outro dado importante apontado nos estudos refere&#8208;se ao estado nutricional antes do tratamento&#44; pois esse pode influenciar os desfechos antropom&#233;tricos p&#243;s&#8208;introdu&#231;&#227;o da TARVc&#46; Bandyopadhyay e Bhattacharyya &#40;2008&#41; mostraram que crian&#231;as desnutridas apresentaram pior resultado na evolu&#231;&#227;o do z&#8208;escores peso&#8208;idade e altura&#8208;idade comparadas &#224;quelas que iniciaram a terapia em condi&#231;&#245;es nutricionais adequadas&#46;<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">44</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">Na revis&#227;o&#44; uma das principais limita&#231;&#245;es &#233; a inclus&#227;o de um grande n&#250;mero de estudos feitos na &#193;frica&#44; onde a car&#234;ncia nutricional pode influenciar indiretamente o controle do crescimento&#44; pode representar um vi&#233;s do uso da TARVc&#46; A desnutri&#231;&#227;o e o atraso no crescimento ocorrem precocemente na infec&#231;&#227;o vertical pelo HIV e o impacto negativo da infec&#231;&#227;o cr&#244;nica e da defici&#234;ncia nutricional&#44; no crescimento&#44; pode ser irrevers&#237;vel&#46;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">32</span></a> No entanto&#44; a aus&#234;ncia de melhoria no padr&#227;o de crescimento ocorreu em estudos feitos em um curto per&#237;odo&#46; Por exemplo&#44; Devi et al&#46; &#40;2011&#41;&#44; que avaliaram 102 pacientes apenas no primeiro ano de uso da TARVc&#46;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">32</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Al&#233;m disso&#44; na revis&#227;o&#44; n&#227;o foi comparado o impacto das diferentes terapias antirretrovirais combinadas entre si&#46; Tamb&#233;m n&#227;o foi poss&#237;vel analisar o crescimento por faixa et&#225;ria&#46; Nenhum estudo comparou grupos sob TARVc&#44; com e sem falha virol&#243;gica&#44; para avaliar o crescimento&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Alguns trabalhos destacaram ainda a necessidade de avaliar as intera&#231;&#245;es entre drogas em crian&#231;as e os potenciais efeitos adversos da TARVc no metabolismo&#44; mas pesquisas ainda s&#227;o limitadas nessa faixa et&#225;ria&#46; Ressalta&#8208;se que os poss&#237;veis efeitos metab&#243;licos da TARVc incluem resist&#234;ncia &#224; insulina&#44; dislipidemia&#44; hiperlactatemia&#44; podem tais altera&#231;&#245;es ocasionar aumento do risco para doen&#231;as cardiovasculares e diabetes&#46; A eleva&#231;&#227;o do colesterol total e a lipodistrofia associada ao uso de TARVc persiste um desafio no tratamento desses pacientes&#46; Fatores associados &#224; ades&#227;o ao tratamento das crian&#231;as a TARVc comprovaram que a baixa ades&#227;o foi fortemente associada ao perfil dos cuidadores &#40;baixa escolaridade e&#47;ou grau de pobreza&#41;&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Com base nos dados aqui descritos&#44; os poss&#237;veis efeitos adversos da TARVc n&#227;o superam os seus benef&#237;cios&#44; em rela&#231;&#227;o ao ganho p&#244;ndero&#8208;estatural e &#224; morbimortalidade das crian&#231;as infectadas pelo HIV&#46; A TARVc conhecidamente atua na melhoria de marcadores virais e imunol&#243;gicos e pode influenciar o crescimento de crian&#231;as infectadas com HIV&#46; No entanto&#44; o aumento dos marcadores antropom&#233;tricos &#40;peso e altura&#41; n&#227;o normalizou o crescimento se comparado &#224; popula&#231;&#227;o saud&#225;vel&#46; Quanto mais precoce o diagn&#243;stico da infec&#231;&#227;o e&#44; concomitantemente&#44; desnutri&#231;&#227;o e in&#237;cio da TARVc&#44; menores ser&#227;o os preju&#237;zos no d&#233;ficit de crescimento&#44; quando comparados aos das crian&#231;as saud&#225;veis&#46; Pacientes com AIDS e sem tratamento pr&#233;vio&#44; por terapia antirretroviral&#44; t&#234;m melhor resposta antropom&#233;trica &#224; TARVc do que pacientes previamente tratados&#46; No entanto&#44; condi&#231;&#245;es socioecon&#244;micas e intrafamiliares desfavor&#225;veis refletem na ades&#227;o ao tratamento&#44; s&#227;o fator limitante para resultados mais significativos e duradouros do uso da TARVc na infec&#231;&#227;o pelo HIV&#46; Finalmente&#44; principalmente em pa&#237;ses com baixos recursos econ&#244;micos para a quantifica&#231;&#227;o da carga viral&#44; a melhoria dos dados antropom&#233;tricos&#44; durante o uso da TARVc&#44; como par&#226;metro de efic&#225;cia terap&#234;utica &#233; mais evidente&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Financiamento</span><p id="par0165" class="elsevierStylePara elsevierViewall">FALM&#44; pela Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de S&#227;o Paulo &#40;Fapesp&#41;&#44; por meio de bolsa de p&#243;s&#8208;doutorado &#40;&#35;2015&#47;12858&#8208;5&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflitos de interesse</span><p id="par0170" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Human immunodeficiency virus infection can result in the early impairment of anthropometric indicators in children and adolescents&#46; However&#44; combined antiretroviral therapy has improved&#44; in addition to the immune response and viral infection&#44; the weight and height development in infected individuals&#46; Therefore&#44; the objective was to evaluate the effect of combined antiretroviral on the growth development of human immunodeficiency virus infected children and adolescents&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Source of data</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A systematic review was performed&#46; In the study&#44; the PRISMA &#40;Preferred Reporting Items for Systematic Reviews and Meta&#8208;Analyses&#41; strategy was used as the eligibility criterion&#46; The MEDLINE&#8208;PubMed and LILACS databases were searched using these descriptors&#58; HIV&#44; children&#44; growth&#44; antiretroviral therapy&#46; The objective was defined by the population&#44; intervention&#44; comparison&#47;control&#44; and outcome &#40;PICO&#41; technique&#46; Inclusion and exclusion criteria were applied for study selection&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Synthesis of data</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Of the 549 studies indexed in MEDLINE&#8208;PubMed and LILACS&#44; 73 were read in full&#44; and 44 were included in the review &#40;33 showed a positive impact of combined antiretroviral therapy on weight&#47;height development&#44; ten on weight gain&#44; and one on height gain in children and adolescents infected with human immunodeficiency virus&#41;&#46; However&#44; the increase in growth was not enough to normalize the height of infected children when compared to children of the same age and gender without human immunodeficiency virus infection&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Combined antiretroviral therapy&#44; which is known to play a role in the improvement of viral and immunological markers&#44; may influence in the weight and height development in children infected with human immunodeficiency virus&#46; The earlier the infection diagnosis and&#44; concomitantly&#44; of malnutrition and the start of combined antiretroviral therapy&#44; the lower the growth impairment when compared to healthy children&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A infec&#231;&#227;o pelo v&#237;rus da imunodefici&#234;ncia humana pode comprometer&#44; precocemente&#44; os indicadores antropom&#233;tricos de crian&#231;as e adolescentes&#46; No entanto&#44; a terapia antirretroviral combinada tem melhorado&#44; al&#233;m da resposta imunol&#243;gica e da infec&#231;&#227;o viral&#44; o ganho p&#244;ndero&#8208;estatural dos infectados&#46; Dessa forma&#44; nosso objetivo foi avaliar o efeito da terapia antirretroviral combinada no crescimento&#44; de crian&#231;as e adolescentes&#44; infectadas pelo v&#237;rus da imunodefici&#234;ncia humana&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Fonte dos dados</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Foi realizada uma revis&#227;o sistem&#225;tica&#46; No estudo&#44; adotou&#8208;se como crit&#233;rio de elegibilidade dos artigos&#44; a estrat&#233;gia PRISMA &#40;<span class="elsevierStyleItalic">preferred reporting items for systematic reviews and meta&#8208;analyses</span>&#41;&#46; Foram consultadas as bases de dados MEDLINE&#8208;PubMed e LILACS pelos descritores&#58; HIV &#40;<span class="elsevierStyleItalic">v&#237;rus da imunodefici&#234;ncia humana&#41;</span>&#44; <span class="elsevierStyleItalic">children</span>&#44; <span class="elsevierStyleItalic">growth</span>&#44; <span class="elsevierStyleItalic">antiretroviral therapy</span>&#46; O objetivo foi definido pela estrat&#233;gia PICO &#40;<span class="elsevierStyleItalic">population</span>&#44; <span class="elsevierStyleItalic">intervention</span>&#44; <span class="elsevierStyleItalic">comparison</span>&#47;<span class="elsevierStyleItalic">control</span>&#44; <span class="elsevierStyleItalic">outcome</span>&#41;&#46; Crit&#233;rios de inclus&#227;o e exclus&#227;o foram aplicados na sele&#231;&#227;o dos estudos&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">S&#237;ntese dos dados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Dos 549 estudos indexados no MEDLINE&#8208;PubMed e LILACS&#44; 73 foram lidos na &#237;ntegra &#8211; 44 inclu&#237;dos na revis&#227;o &#40;33 demonstraram impacto positivo da terapia antirretroviral combinada no ganho p&#244;ndero&#8208;estatural&#44; dez no ganho de peso e um no de estatura&#44; em crian&#231;as e adolescentes&#44; infectados com v&#237;rus da imunodefici&#234;ncia humana&#41;&#46; No entanto&#44; o incremento no crescimento n&#227;o foi o suficiente para normalizar a estatura de crian&#231;as infectadas&#44; quando comparado com crian&#231;as da mesma idade e sexo&#44; sem infec&#231;&#227;o pelo v&#237;rus da imunodefici&#234;ncia humana&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A terapia antirretroviral combinada que&#44; conhecidamente&#44; atua na melhora de marcadores virais e imunol&#243;gicos&#44; pode influenciar no ganho p&#244;ndero&#8208;estatural de crian&#231;as infectadas com v&#237;rus da imunodefici&#234;ncia humana&#46; Quanto mais precoce o diagn&#243;stico da infec&#231;&#227;o e&#44; concomitante&#44; desnutri&#231;&#227;o e in&#237;cio da terapia antirretroviral combinada&#44; menores ser&#227;o os preju&#237;zos no crescimento&#44; quando comparado &#224;s crian&#231;as saud&#225;veis&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0025">O estudo foi feito na Faculdade de Ci&#234;ncias M&#233;dicas&#44; Universidade Estadual de Campinas&#44; Campinas&#44; SP&#44; Brasil&#46;</p>"
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          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diagrama de fluxo de sele&#231;&#227;o dos artigos usados na revis&#227;o sistem&#225;tica&#46; Lilacs&#44; Literatura Latino&#8208;Americana e do Caribe em Ci&#234;ncias da Sa&#250;de&#59; Medline&#8208;PubMed&#44; <span class="elsevierStyleItalic">Medical Literature Analysis and Retrieval System Online &#8211; Public Medline</span>&#46;</p>"
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          "pt" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Desfecho associado ao crescimento relacionado ao uso da TARVc&#44; em crian&#231;as e adolescentes&#44; infectados pelo HIV&#46; TARVc&#44; terapia antirretroviral combinada&#59; HIV&#44; v&#237;rus da imunodefici&#234;ncia humana<span class="elsevierStyleItalic">&#59;</span> LT CD4<span class="elsevierStyleSup">&#43;</span>&#44; linf&#243;citos CD4<span class="elsevierStyleSup">&#43;</span>&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">EUA&#44; Estados Unidos da Am&#233;rica&#59; GR&#44; grau de recomenda&#231;&#227;o&#59; HAART&#44; <span class="elsevierStyleItalic">highly active antiretroviral therapy</span>&#59; IMC&#44; &#237;ndice de massa corp&#243;rea&#59; LT CD4<span class="elsevierStyleSup">&#43;</span>&#44; linf&#243;citos CD4<span class="elsevierStyleSup">&#43;</span>&#59; NE&#44; n&#237;vel de evid&#234;ncia&#59; TARVc&#44; terapia antirretroviral combinada&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Estudo &#40;ano&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Local&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Desenho do estudo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Indiv&#237;duos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Resultados principais&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">GR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jesson et al&#46; &#40;2017&#41;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">10</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte prospectiva<br>6 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">158 crian&#231;as<br>1 a 15 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso e redu&#231;&#227;o de anemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ramteke et al&#46; &#40;2017&#41;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte longitudinal<br>1 ano&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">553 crian&#231;as &#40;300 controles&#41;<br>4 a 9 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso e estatura&#46; No entanto&#44; o peso e estatura n&#227;o estavam dentro dos par&#226;metros de normalidade quando comparados com o grupo controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cames et al&#46; &#40;2017&#41;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">8</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Senegal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte prospectiva<br>2 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">244 crian&#231;as<br>2 a 16 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de altura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ebissa et al&#46; &#40;2016&#41;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Eti&#243;pia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte retrospectiva<br>2 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">556 crian&#231;as<br>1 a 10 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso e estatura e aumento de linf&#243;citos LT CD4<span class="elsevierStyleSup">&#43;</span>&#46;<br>O efeito foi maior nas crian&#231;as abaixo do peso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Achan et al&#46; &#40;2016&#41;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">18</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ensaio randomizado<br>3 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">129 crian&#231;as<br>2 meses a 6 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de estatura e peso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hu et al&#46; &#40;2016&#41;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">China&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte retrospectiva<br>2 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">744 crian&#231;as<br>0 a 15 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso e estatura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Feucht et al&#46; &#40;2016&#41;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">20</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica do Sul&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte observacional<br>3 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">159 crian&#231;as<br>Menores de 5 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria de z&#8208;escore de peso e IMC&#44; nos primeiros 12 meses&#44; e do<br>z&#8208;escore de estatura&#44; ao longo dos 3 anos de acompanhamento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Schomaker et al&#46; &#40;2016&#41;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte prospectiva<br>3 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;826 crian&#231;as<br>2 a 5 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso e estatura e aumento de linf&#243;citos LT CD4<span class="elsevierStyleSup">&#43;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tekleab et al&#46; &#40;2016&#41;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">22</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Eti&#243;pia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo<br>3 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">202 crian&#231;as<br>2 a 5 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria de z&#8208;escore peso e estatura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chattopadhyay et al&#46; &#40;2016&#41;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">23</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#205;ndia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Transversal<br>1 ano&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56 crian&#231;as<br>&#40;60 controles&#41;<br>2 a 10 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso e estatura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yotebieng et al&#46; &#40;2015&#41;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">24</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica e<br>&#193;sia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retrospectivo<br>2 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;173 crian&#231;as<br>0 a 10 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore peso&#8208;idade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kariminia et al&#46; &#40;2014&#41;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">25</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;sia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte retrospectiva<br>9 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;608 pacientes<br>0 a15 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso e estatura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Shiau et al&#46; &#40;2013&#41;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica do Sul&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo<br>4 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">195 pacientes<br>0 a 2 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Crian&#231;as que iniciaram TARVc antes dos 6 meses de idade apresentaram melhoria mais r&#225;pida no z&#8208;escore de peso e estatura quando comparada as que iniciaram depois&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chhagan et al&#46; &#40;2012&#41;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">27</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo<br>2 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">151 crian&#231;as<br>pr&#233;&#8208;p&#250;beres&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">HAART mostrou associa&#231;&#227;o com aumento no z&#8208;escore peso&#8208;idade e altura&#8208;idade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gsponer et al&#46; &#40;2012&#41;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">28</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica e<br>&#193;frica do Sul&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte retrospectiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;990 pacientes<br>0 a 10 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria de z&#8208;escore peso e estatura&#46; No entanto&#44; o peso e estatura&#44; para o par&#226;metro dentro da curva de normalidade para a idade n&#227;o foram alcan&#231;ados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sutcliffe et al&#46; &#40;2011&#41;<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">29</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Z&#226;mbia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte prospectiva<br>2 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">193 pacientes<br>0 a 16 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso e estatura&#46; O efeito foi maior nas crian&#231;as abaixo do peso&#44; j&#225; o menor z&#8208;escore estatura ocorreu em crian&#231;as acima de 5 anos&#46; Ap&#243;s 2 anos de tratamento&#44; uma grande parte das crian&#231;as&#44; permaneceu abaixo do peso e estatura para idade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">McGratha et al&#46; &#40;2011&#41;<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">30</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Qu&#234;nia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte prospectiva<br>4 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">173 pacientes<br>0 a 10 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso para idade&#44; sendo maior em crian&#231;as abaixo de 6 anos&#46; N&#227;o houve melhoria no z&#8208;escore de estatura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diniz et al&#46; &#40;2011&#41;<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">31</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Brasil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retrospectivo<br>3 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">196 pacientes<br>0 a 12 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Foi observada melhor resposta imune e z&#8208;escore&#44; peso e altura&#44; ao final do seguimento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Devi et al&#46; &#40;2011&#41;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">32</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#205;ndia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo<br>1 ano&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">102 pacientes<br>idade m&#233;dia &#61; 74 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No primeiro ano de TARVc houve melhoria na resposta imune e no z&#8208;escore peso&#44; mas n&#227;o de altura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Naidoo et al&#46; &#40;2010&#41;<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">33</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica do Sul&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retrospectivo<br>8 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">120 crian&#231;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z escore de peso e estatura&#46; N&#227;o houve efeito na estatura das crian&#231;as com desnutri&#231;&#227;o grave&#46; Houve aumento de linf&#243;citos LT CD4<span class="elsevierStyleSup">&#43;</span> e redu&#231;&#227;o da carga viral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chantry et al&#46; &#40;2010&#41;<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">34</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EUA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo&#47;coorte &#8211;<br>48 semanas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97 pacientes &#8211; 1 m&#234;s a 13 anos incompletos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Indiv&#237;duos que estavam iniciando ou mudando a TARVc foram comparados com grupo controle &#40;crian&#231;as expostas ao HIV&#44; mas n&#227;o infectadas e dados demogr&#225;ficos e antropom&#233;tricos de estudo americano&#41;&#46; Houve melhoria no z&#8208;escore de peso e estatura&#44; por&#233;m sem mudan&#231;a no z&#8208;escore de IMC&#46; No entanto&#44; o peso e estatura foram inferiores a popula&#231;&#227;o saud&#225;vel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yotebieng et al&#46; &#40;2010&#41;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">35</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica do Sul&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte prospectiva &#8211; 4 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;394 pacientes<br>0 a15 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso&#44; por&#233;m sem alterar o z&#8208;escore de estatura&#46; Al&#233;m disso&#44; houve melhoria na contagem de LT CD4<span class="elsevierStyleSup">&#43;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weigel et al&#46; &#40;2010&#41;<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">36</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Malawi&#44; &#193;frica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 24 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">307 pacientes menores de 15 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ocorreu associa&#231;&#227;o entre resposta imune e melhoria no z&#8208;escore peso e altura no fim do seguimento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Musoke et al&#46; &#40;2010&#41;<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">37</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uganda&#44; &#193;frica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 48 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130 pacientes<br>6 meses a 12 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Aumento do z&#8208;escore peso e altura&#44; com tratamento&#44; especialmente nos indiv&#237;duos que iniciaram a terapia mais jovens&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Aurpibul et al&#46; &#40;2009&#41;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">38</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Tail&#226;ndia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte &#8211; 5 anos<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">225 pacientes<br>0 a 15 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Feita compara&#231;&#227;o com dados antropom&#233;tricos de refer&#234;ncia para crian&#231;as tailandesas&#44; sem grupo controle&#46; Houve efeito positivo no z&#8208;escore de peso e estatura&#46; Ao mesmo tempo&#44; houve aumento na contagem de LT CD4<span class="elsevierStyleSup">&#43;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Davies et al&#46; &#40;2009&#41;<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">39</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica do Sul&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte prospectiva &#8211; 9 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;078 pacientes<br>0 a 16 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso e estatura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kabue et al&#46; &#40;2008&#41;<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">40</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uganda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retrospectivo &#8211; 3 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">749 pacientes &#8208;<br>0 a 19 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore peso&#8208;idade e altura&#8208;idade&#46; N&#227;o foi avaliada a resposta viral ou imune&#46; Al&#233;m disso&#44; no estudo n&#227;o &#233; especificado o uso da HAART&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Buonora et al&#46; &#40;2008&#41;<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">41</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Brasil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retrospectivo &#8211; 97 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">108 pacientes<br>10 a 20 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mesmo com a HAART&#44; o z&#8208;escore altura&#8208;idade e peso&#8208;idade foram menores do que quando comparados a indiv&#237;duos saud&#225;veis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kekitiinwa et al&#46; &#40;2008&#41;<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">42</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Reino Unido&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 12 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;458 crian&#231;as<br>Idade m&#233;dia 5 e 7&#44;6 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escores peso&#8208;idade e altura&#8208;idade&#44; principalmente nas crian&#231;as com menor idade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jaspan et al&#46; &#40;2008&#41;<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">43</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#193;frica do Sul&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte retrospectiva &#8211; 4 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">391 pacientes<br>9 a 59 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore de peso&#44; por&#233;m a estatura n&#227;o foi avaliada&#46; Al&#233;m disso&#44; foi observado o aumento de LT CD4<span class="elsevierStyleSup">&#43;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bandyopadhyay and Bhattacharyya &#40;2008&#41;<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">44</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#205;ndia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 18 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">123<br>2 meses a 8 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A desnutri&#231;&#227;o antes do in&#237;cio da TARVc pode prejudicar o resultado nos par&#226;metros nutricionais&#44; houve melhoria somente do z&#8208;escore de peso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Zhang et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">45</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">China&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 12 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83 crian&#231;as &#8211; 7 a 13 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore peso e altura e na resposta imune dos pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Wamalwa et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">46</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Qu&#234;nia&#44; &#193;frica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 9 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67 crian&#231;as<br>18 meses a 12 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore peso&#8208;idade e altura&#8208;idade&#46; Al&#233;m disso&#44; a resposta cl&#237;nica e controle viral&#44; apresentaram melhores resultados na uso de de HAART&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Song et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">47</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Qu&#234;nia&#44; &#193;frica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retrospectivo &#8211; 1 ano&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 crian&#231;as &#8208;<br>idade m&#233;dia &#61; 8&#44;5 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore peso&#8208;idade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Guillen et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">48</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Espanha&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retrospectivo &#8211; 5 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">264 pacientes<br>0 a 18 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore peso e altura e no controle viral nos 5 primeiros anos de TARVc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nachman et al&#46; &#40;2005&#41;<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">49</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EUA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 2 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">192 crian&#231;as<br>4 meses a 17 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">HAART possibilitou aumento no z&#8208;escore peso&#8208;idade na semana 48 e altura&#8208;idade na semana 96&#46; Crian&#231;as com menor idade ganharam peso em menor tempo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lodha et al&#46; &#40;2005&#41;<a class="elsevierStyleCrossRef" href="#bib0540"><span class="elsevierStyleSup">50</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#205;ndia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 6 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 crian&#231;as &#8211; idade m&#233;dia &#61; 5&#44;6 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore peso&#8208;idade durante o per&#237;odo de 6 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ghaffari et al&#46; &#40;2004&#41;<a class="elsevierStyleCrossRef" href="#bib0545"><span class="elsevierStyleSup">51</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EUA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 2 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 crian&#231;as<br>2 a18 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhor resposta imune e maior z&#8208;escore peso e altura ao final do seguimento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kline et al&#46; &#40;2004&#41;<a class="elsevierStyleCrossRef" href="#bib0550"><span class="elsevierStyleSup">52</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rom&#234;nia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 67 semanas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">452 crian&#231;as<br>0 a 18 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore peso e altura e na resposta imune&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Newell et al&#46; &#40;2003&#41;<a class="elsevierStyleCrossRef" href="#bib0555"><span class="elsevierStyleSup">53</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Europa &#40;11 pa&#237;ses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 10 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;587 pacientes<br>0 a10 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore peso e altura com TARVc&#44; independente da classifica&#231;&#227;o cl&#237;nica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Verwell et al&#46; &#40;2002&#41;<a class="elsevierStyleCrossRef" href="#bib0560"><span class="elsevierStyleSup">54</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Holanda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estudo prospectivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 crian&#231;as &#8211; 4 meses a 16 anos &#40;96 semanas de tratamento&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">N&#227;o foi inclu&#237;do grupo controle&#44; mas sim curvas de refer&#234;ncia da Holanda&#46; Melhoria no z&#8208;escore peso e estatura&#44; nos pacientes&#44; com redu&#231;&#227;o da carga viral e no z&#8208;escore IMC&#44; nos pacientes&#44; com est&#225;gio avan&#231;ado da doen&#231;a e desnutridos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nachman et al&#46; &#40;2002&#41;<a class="elsevierStyleCrossRef" href="#bib0565"><span class="elsevierStyleSup">55</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EUA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 120 semanas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">197 pacientes &#8211; 2 a 17 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Foi descrito que o d&#233;ficit de crescimento se acentuava ao longo do tempo&#44; mesmo nos indiv&#237;duos com melhor controle da carga viral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Miller et al&#46; &#40;2001&#41;<a class="elsevierStyleCrossRef" href="#bib0570"><span class="elsevierStyleSup">56</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EUA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Coorte &#8211; 3 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67 pacientes &#8211; 0 a 3&#44;8 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">N&#227;o foi inclu&#237;do grupo controle&#46; Melhoria no z&#8208;escore peso e peso&#47;estatura&#44; bem como&#44; na redu&#231;&#227;o da carga viral&#44; por&#233;m n&#227;o houve efeito na estatura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Buchacz et al&#46; &#40;2001&#41;<a class="elsevierStyleCrossRef" href="#bib0575"><span class="elsevierStyleSup">57</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EUA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Prospectivo &#8211; 3 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">906 pacientes &#8211; 3 meses a 18 anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melhoria no z&#8208;escore peso e altura com TARVc contendo inibidor de protease&#44; independentemente da classifica&#231;&#227;o cl&#237;nica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Dados obtidos nos estudos de acordo com ano de publica&#231;&#227;o&#44; local do estudo&#44; desenho usado na pesquisa&#44; amostra avaliada&#44; principais resultados obtidos&#44; grau de recomenda&#231;&#227;o e n&#237;vel de evid&#234;ncia</p>"
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          "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Desfecho relacionado ao ganho p&#244;ndero&#8208;estatural&#44; em pacientes infectados pelo HIV &#40;n&#250;mero de infectados totais &#61; 51&#46;992 crian&#231;as e adolescentes&#41;&#44; submetidos a terapia com TARVc</p>"
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