Comparative growth of children who are HIV-exposed and uninfected with those who are HIV-unexposed and uninfected at age 1 and 2 years in South Africa: a prospective cohort study

作者：Anna Carlqvist, Michelle Fernandes, Leila Cheikh Ismail, José Villar, Stephen Kennedy, Aris T. Papageorghiou, Eric O. Ohuma, Rachel Craik, Zulfiqar A Bhutta, Ann Lambert, Shane A. Norris, Maria Quigley, Joris Hemelaar · 发表于：EClinicalMedicine · 年份：2025 · DOI：10.1016/j.eclinm.2025.103515 · 被引用次数：5 · 研究领域：HIV-related health complications and treatments、HIV/AIDS Research and Interventions、Birth, Development, and Health

Background: The effects of maternal HIV infection and antiretroviral therapy (ART) on growth of children who are HIV-exposed and uninfected (CHEU) are uncertain. We aimed to explore the association between in utero exposure to maternal HIV and child growth in the context of ART for all pregnant women living with HIV regardless of CD4 count. Methods: We compared growth at 1 and 2 years of age between CHEU and children who are HIV-unexposed and uninfected (CHUU) in a prospective cohort study (INTERBIO-21st), conducted in Soweto, South Africa, with recruitment of pregnant women between 21 May 2013 and 21 December 2015. Length-for-age (LAZ), weight-for-age (WAZ), weight-for-length (WLZ) and head circumference-for-age (HCAZ) Z-scores, based on the World Health Organization (WHO) Child Growth Standards, were compared longitudinally using age-specific and mixed linear regression. Prevalence of stunting, underweight, wasting and overweight were compared at 1 and 2 years. Findings: At 1 and 2 years of age, 398 (143 CHEU, 255 CHUU) and 286 (82 CHEU, 204 CHUU) children, respectively, were followed up. CHEU and CHUU had LAZ and WAZ scores considerably below the WHO standardised median at 1 year (CHEU: mean (SD) LAZ -1.13 (1.39), WAZ -0.29 (1.33); CHUU: LAZ -0.87 (1.33), WAZ -0.15 (1.20)) and 2 years (CHEU: LAZ -1.00 (1.24), WAZ -0.52 (1.05); CHUU: LAZ -0.94 (1.33), WAZ -0.34 (1.19)), whereas WLZ scores were above the median at year 1 only (CHEU 0.34 (1.27), CHUU 0.42 (1.28). There were n...