Journal
PEDIATRIC INFECTIOUS DISEASE JOURNAL
Volume 36, Issue 9, Pages 869-876Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/INF.0000000000001574
Keywords
HIV; children; growth; stunting; wasting; Zimbabwe
Categories
Funding
- Canadian international Development Agency (CIDA) (R/C Project) [690/M3688]
- United States Agency fur International Development (USAID) [HRN-A-00-97-00015-00]
- Bill and Melinda Gates Foundation, Seattle, WA
- SARA Project
- USAID's Bureau for Africa, Office of Sustainable Development [AOT-C-00-99-00237-00]
- Rockefeller Foundation (New York, NY)
- BASF (Ludwigshafen, Germany)
- IHV-UM NIH Fogarty AIDS international Training Research Program (AITRP) [D43 TW001041]
- National Institute fix Health Research
- Wellcome Trust [108065/Z/15/2]
- National Institute for Health Research [ACF-2014-19-007] Funding Source: researchfish
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Background: Growth failure is common among HIV-infected infants, but there are limited data on the effects of HIV exposure or timing of HIV acquisition on growth. Methods: Fourteen thousand one hundred ten infants were enrolled in the Zimbabwe Vitamin A for Mothers and Babies trial in Zimbabwe before the availability of antiretroviral therapy or co-trimoxazole. Anthropometric measurements were taken from birth through 12-24 months of age. Growth outcomes were compared between 5 groups of children: HIV-infected in utero (IU), intrapartum (IP) or postnatally (PN); HIV-exposed uninfected (HEU); and HIV unexposed. Results: Growth failure was common across all groups of children. Compared with HIV-unexposed children, IU-, IP-and PN-infected children had significantly lower length-for-age and weight-for-length Z scores throughout the first 2 years of life. At 12 months, odds ratios for stunting were higher in IU [ 6.25, 95% confidence interval (CI): 4.20-9.31] and IP infants (4.76, 95% CI: 3.58-6.33) than in PN infants (1.70, 95% CI: 1.16-2.47). Compared with HIV-unexposed infants, HEU infants at 12 months had odds ratios for stunting of 1.23 (95% CI: 1.08-1.39) and wasting of 1.56 (95% CI: 1.22-2.00). Conclusions: HIV-infected infants had very high rates of growth failure during the first 2 years of life, particularly if IU or IP infected, highlighting the importance of early infant diagnosis and antiretroviral therapy. HEU infants had poorer growth than HIV-unexposed infants in the first 12 months of life.
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