Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pediatrics
Published in: BMC Pediatrics 1/2017

Open Access 01-12-2017 | Research article

Growth of HIV-exposed uninfected, compared with HIV-unexposed, Zambian children: a longitudinal analysis from infancy to school age

Authors: Anna Rosala-Hallas, Jonathan W. Bartlett, Suzanne Filteau

Published in: BMC Pediatrics | Issue 1/2017

Login to get access

Abstract

Background

Early growth of HIV-exposed, uninfected (HEU) children is poorer than that of their HIV-unexposed, uninfected (HUU) counterparts but there is little longitudinal or longer term information about the growth effects of early HIV exposure.

Methods

We performed a longitudinal analysis to compare growth of HEU and HUU infants and children using data from two cohort studies in Lusaka, Zambia. Initially 207 HUU and 200 HEU infants from the Breastfeeding and Postpartum Health (BFPH) study and 580 HUU and 165 HEU from the Chilenje Infant Growth, Nutrition and Infection Study (CIGNIS) had anthropometric measurements taken during infancy and again when school-aged, at which time 66 BFPH children and 326 CIGNIS children were available. We analysed the data from the two cohorts separately using linear mixed models. Linear regression models were used as a secondary analysis at the later time points, adjusting for breastfeeding duration. We explored when the main group differences in growth emerged in order to estimate the largest ‘effect periods’.

Results

After adjusting for socioeconomic status and maternal education, HEU children had lower weight-for-age, length-for-age and BMI-for-age Z-scores during early growth and these differences still existed when children were school-aged. Exposure group differences changed most between 1 and 6 weeks and between 18 months and ~7.5 years.

Conclusions

HEU children have poorer early growth than HUU children which persists into later growth. Interventions to improve growth of HEU children need to target pregnant women and infants.
Appendix
Available only for authorised users
Literature
1.
2.
3.
Newell ML, Borja MC, Peckham C, European Collaborative S. Height, weight, and growth in children born to mothers with HIV-1 infection in Europe. Pediatrics. 2003;111(1):e52–60.CrossRefPubMed
4.
5.
Filteau S, Baisley K, Chisenga, Kasonka L, Gibson R, CIGNIS Study Team. Provision of micronutrient-fortified food from 6 months of age does not permit HIV-exposed, uninfected Zambian children to catch up in growth to HIV-unexposed children: a randomised controlled trial. J AIDS. 2011;56:166–75.
6.
Makasa M, Kasonka L, Chisenga M, Sinkala M, Chintu C, Tomkins A, et al. Early growth of infants of HIV-infected and uninfected Zambian women. Trop Med Int Health. 2007;12(5):594–602.CrossRefPubMed
7.
Powis KM, Smeaton L, Ogwu A, Lockman S, Dryden-Peterson S, van Widenfelt E, et al. Effects of in utero antiretroviral exposure on longitudinal growth of HIV-exposed uninfected infants in Botswana. J Acquir Immune Defic Syndr. 2011;56(2):131–8.CrossRefPubMedPubMedCentral
8.
Muhangi L, Lule SA, Mpairwe H, Ndibazza J, Kizza M, Nampijja M, et al. Maternal HIV infection and other factors associated with growth outcomes of HIV-uninfected infants in Entebbe, Uganda. Public Health Nutr. 2013;16(9):1548–57.CrossRefPubMedPubMedCentral
9.
Ramokolo V, Lombard C, Fadnes LT, Doherty T, Jackson DJ, Goga AE, et al. HIV infection, viral load, low birth weight, and nevirapine are independent influences on growth velocity in HIV-exposed South African infants. J Nutr. 2014;144(1):42–8.CrossRefPubMed
10.
McGrath CJ, Nduati R, Richardson BA, Kristal AR, Mbori-Ngacha D, Farquhar C, et al. The prevalence of stunting is high in HIV-1-exposed uninfected infants in Kenya. J Nutr. 2012;142(4):757–63.CrossRefPubMedPubMedCentral
11.
12.
Kasonka L, Makasa M, Marshall T, Chisenga M, Sinkala M, Chintu C, et al. Risk factors for subclinical mastitis among HIV-infected and uninfected women in Lusaka, Zambia. Paediatr Perinat Epidemiol. 2006;20(5):379–91.CrossRefPubMed
13.
Chisenga M, Kasonka L, Makasa M, Sinkala M, Chintu C, Kaseba C, et al. Factors affecting the duration of exclusive breastfeeding among HIV-infected and -uninfected women in Lusaka, Zambia. J Hum Lact. 2005;21(3):266–75.CrossRefPubMed
14.
Nicholson L, Chisenga M, Siame J, Kasonka L, Filteau S. Growth and health outcomes at school age in HIV-exposed, uninfected Zambian children: follow-up of two cohorts studied in infancy. BMC Pediatr. 2015;15:66.CrossRefPubMedPubMedCentral
15.
Chilenje Infant Growth Nutrition and Infection (CIGNIS) Study Team. Micronutrient fortification to improve growth and health of maternally HIV-unexposed and exposed Zambian infants: a randomised controlled trial. PLoS One. 2010;5(6):e11165.CrossRef
16.
Chisenga M, Siame J, Baisley K, Kasonka L, Filteau S. Determinants of infant feeding choices by Zambian mothers: a mixed quantitative and qualitative study. Matern Child Nutr. 2011;7:148–59.CrossRefPubMed
17.
Filteau S, Baisley K, Chisenga M, Kasonka L, Gibson RS, Team CS. Provision of micronutrient-fortified food from 6 months of age does not permit HIV-exposed uninfected Zambian children to catch up in growth to HIV-unexposed children: a randomized controlled trial. J Acquir Immune Defic Syndr. 2011;56(2):166–75.CrossRefPubMed
18.
Gibson RS. Principles of Nutritional Assessment. 2nd Edition ed. Oxford: Oxford University Press; 2005.
19.
Ulijaszek S, Kerr D. Anthropometric measurement error and the assessment of nutritional status. Br J Nutr. 1999;82:165–77.CrossRefPubMed
20.
21.
Beunckens C, Molenberghs G, Kenward MG. Direct likelihood analysis versus simple forms of imputation for missing data in randomized clinical trials. Clin Trials. 2005;2(5):379–86.CrossRefPubMed
22.
Venkatesh KK, Lurie MN, Triche EW, De Bruyn G, Harwell JI, McGarvey ST, et al. Growth of infants born to HIV-infected women in South Africa according to maternal and infant characteristics. Trop Med Int Health. 2010;15(11):1364–74.CrossRefPubMed
23.
Arpadi S, Fawzy A, Aldrovandi G, Kankasa C, Sinkala M, Mwiya M, et al. Growth faltering due to breastfeeding cessation in uninfected children born to HIV-infected mothers in Zambia. Am J Clin Nutr. 2009;90:344–53.CrossRefPubMedPubMedCentral
24.
Chilenje Infant Growth N, Infection Study T. Micronutrient fortification to improve growth and health of maternally HIV-unexposed and exposed Zambian infants: a randomised controlled trial. PLoS One. 2010;5(6):e11165.CrossRef
25.
Bobat R, Coovadia H, Moodley D, Coutsoudis A, Gouws E. Growth in early childhood in a cohort of children born to HIV-1-infected women from Durban, South Africa. Ann Trop Paediatr. 2001;21(3):203–10.CrossRefPubMed
26.
Owor M, Mwatha A, Donnell D, Musoke P, Mmiro F, Allen M, et al. Long-term follow-up of children in the HIVNET 012 perinatal HIV prevention trial: five-year growth and survival. J Acquir Immune Defic Syndr. 2013;64(5):464–71.CrossRefPubMedPubMedCentral
Metadata
Title
Growth of HIV-exposed uninfected, compared with HIV-unexposed, Zambian children: a longitudinal analysis from infancy to school age
Authors
Anna Rosala-Hallas
Jonathan W. Bartlett
Suzanne Filteau
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2017
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-017-0828-6

Other articles of this Issue 1/2017

BMC Pediatrics 1/2017 Go to the issue

Research article

Validity of a simplified screening instrument for assessing overweight children in a dental setting: a cross sectional study

Research article

Emotional and behavioural problems in Swedish preschool children rated by preschool teachers with the Strengths and Difficulties Questionnaire (SDQ)

Research article

Healthcare-seeking behaviour of primary caregivers for acute otitis media in children aged 6 months to <30 months in Panama: results of a cross-sectional survey

Research article

Reliability and validity of pediatric triage tools evaluated in Low resource settings: a systematic review

Debate

Do systematic reviews on pediatric topics need special methodological considerations?

Research article

Early childhood obesity: a survey of knowledge and practices of physicians from the Middle East and North Africa