In-utero HIV exposure and cardiometabolic health among children 5–8 years: findings from a prospective birth cohort in South Africa. (1st January 2023)

• Record Type: Journal Article
• Authors: Bengtson, Angela M.; Pellowski, Jennifer; McGarvey, Stephen; McGinty, Rae; Botha, Maresa; Burd, Tiffany; Burgner, David; Mansell, Toby; Zar, Heather J.
• Is Part Of: AIDS. Volume 37:Number 1(2023)
• Page Start: 173
• Page End: 182
• Publication Date: 2023-01-01
• Subjects: blood pressure -- body composition -- cardiometabolic health -- glucose metabolism -- HIV exposure -- lipids; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000003412
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Objective: To evaluate if in-utero HIV exposure is associated with adverse cardiometabolic health outcomes at 5–8 years of age. Design: Prospective cohort study. Methods: We enrolled a random sample of HIV-exposed but uninfected (HEU) and HIV-unexposed children from the Drakenstein Child Health study, a longitudinal birth cohort study in Cape Town, South Africa, in a cardiometabolic health pilot study. Outcomes were assessed by trained study staff and included: anthropometry, body composition and size, blood pressure, fasting plasma glucose, HbA1c, lipids, and insulin resistance using HOMA-IR. We used multivariable linear and log-binomial regression to estimate associations between HIV-exposure and cardiometabolic outcomes, adjusted for child age, sex, height, body size, and maternal factors as appropriate. Results: We included 260 children (HEU n = 100, HIV-unexposed n = 160). HEU children had older mothers (median age 30 vs. 26 years), with minimal differences in gestational age and size at birth by HIV-exposure status. In multivariable analyses, HEU children had lower weight-for-age (mean difference −0.35, 95% confidence interval −0.66, −0.05), and height-for-age (mean difference −0.29, 95% confidence interval −0.56, −0.03; z -scores). There were no differences in adiposity, impaired glucose metabolism, or lipid levels by HIV-exposure status. Overall, 12% of children had blood pressure more than 90th percentile, with no differences by HIV-exposure status. Conclusion: Overall, there were few differences in cardiometabolic outcomes between HEU and HIV-unexposed children in this South African cohort. Although these findings are reassuring, monitoring of cardiometabolic health is important as HEU and HIV-unexposed children enter adolescence and cardiometabolic risk trajectories become established.