HIV-Exposed, Uninfected Infants in Uganda Experience Poorer Growth and Body Composition Trajectories than HIV-Unexposed Infants. (1st October 2020)

• Record Type: Journal Article
• Authors: Lane, Charlotte E.; Widen, Elizabeth M.; Collins, Shalean M.; Young, Sera L.
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 85:Number 2(2020)
• Publication Date: 2020-10-01
• Subjects: HIV-exposed and -uninfected -- anthropometry -- HAZ -- LAZ -- sum of skinfolds -- MUAC; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000002428
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Background: HIV-uninfected infants of HIV-positive women may experience worse growth and health outcomes than infants of HIV-negative women, but this has not been thoroughly investigated under the World Health Organization's most recent recommendations to reduce vertical transmission. Objective: To determine whether HIV-exposed and -uninfected (HEU) infants whose mothers received Option B+ have higher odds of experiencing suboptimal growth trajectories than HIV-unexposed, -uninfected infants, and if this relationship is affected by food insecurity. Design: Repeated anthropometric measures were taken on 238 infants (HEU = 86) at 1 week and 1, 3, 6, 9, and 12 months after delivery in Gulu, Uganda. Latent class growth mixture modeling was used to develop trajectories for length-for-age z-scores, weight-for-length z-scores, mid-upper arm circumference, sum of skinfolds, and arm fat area. Multinomial logistic models were also built to predict odds of trajectory class membership, controlling for socioeconomic factors. Results: HEU infants had greater odds of being in the shortest 2 length-for-age z-scores trajectory classes [odds ratio (OR) = 3.80 (1.22–11.82), OR = 8.72 (1.80–42.09)] and higher odds of being in smallest sum of skinfolds trajectory class [OR = 3.85 (1.39–10.59)] vs. unexposed infants. Among HEU infants, increasing food insecurity was associated with lower odds of being in the lowest sum of skinfolds class [OR = 0.86 (0.76–0.98)]. Conclusions: There continues to be differences in growth patterns by HIV-exposure under the new set of World Health Organization guidelines for the prevention of mother-to-child transmission of HIV and the feeding of HEU infants in low-resource settings that are not readily identified through traditional mixed‐effects modeling. Food insecurity was not associated with class membership, but differentially affected adiposity by HIV-exposure status. Abstract : Supplemental Digital Content is Available in the Text.