Growth deficits persist for HIV-exposed children

Children exposed to HIV in utero but who remained uninfected appear to have suboptimal growth outcomes up to 8 years of age when compared with their unexposed peers, according to the Drakenstein Child Health Study.

The study included 236 and 836 children born to women with and without HIV at 20–28 weeks’ gestation, respectively. These children and their mothers were followed up at least annually until age 8 years of age.

The primary outcome was differences in anthropometry, which was converted to sex-specific weight-for-age Z scores (WAZ), length-for-age or height-for-age Z scores (HAZ), and BMI-for-age Z scores (BMIZ) per WHO growth standards. All outcomes were assessed in all children with anthropometry data after birth. Secondary outcomes included stunting (HAZ of less than –2 standard deviation [SD] from age 12 months) and overweight (BMIZ of greater than 2 SD from age 6 months).

Mean birthweight was 3,012 g in the exposed group vs 3,041 g in the unexposed group, and 18.3 percent and 15 percent of infants in the respective groups were born preterm.

Compared with children in the unexposed group, those in the exposed group had lower overall WAZ (marginal difference, –0.16) and HAZ (marginal difference, –0.26) from age 6 weeks to 8 years. Age-specific differences were largest before age 6 months for WAZ and before age 3 years for HAZ.

There were no significant differences observed in BMIZ (marginal difference, –0.02), stunting (marginal difference, 0.05), and overweight (marginal difference, –0.01) from age 6 weeks to 8 years between the exposed and unexposed groups.