Higher prevalence of stunting and poor growth outcomes in HIV-exposed uninfected than HIV-unexposed infants in Kenya

NEARY, Jillian; LANGAT, Agnes; SINGA, Benson; KINUTHIA, John; ITINDI, Janet; NYABOE, Edward; NG’ANGA, Lucy W.; KATANA, Abraham; JOHN-STEWART, Grace C.; MCGRATH, Christine J.

doi:10.1097/QAD.0000000000003124

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Higher prevalence of stunting and poor growth outcomes in HIV-exposed uninfected than HIV-unexposed infants in Kenya

3 15 2022
By NEARY, Jillian ; LANGAT, Agnes ; SINGA, Benson ; ...
http://dx.doi.org/10.1097/QAD.0000000000003124
Source: AIDS. 36(4):605-610

[PDF-87.60 KB]

English

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Details:

Alternative Title:

AIDS
Personal Author:

NEARY, Jillian ; LANGAT, Agnes ; SINGA, Benson ; KINUTHIA, John ; ITINDI, Janet ; ... More +

NEARY, Jillian ; LANGAT, Agnes ; SINGA, Benson ; KINUTHIA, John ; ITINDI, Janet ; NYABOE, Edward ; NG’ANGA, Lucy W. ; KATANA, Abraham ; JOHN-STEWART, Grace C. ; MCGRATH, Christine J. Less -
Description:

Background:

With the growing population of HIV-exposed uninfected (HEU) children globally, it is important to determine population-level growth differences between HEU and HIV-unexposed uninfected (HUU) children.

Methods:

We analyzed data from a population-level survey enrolling mother-infant pairs attending 6-week and 9-month immunizations in 140 clinics across Kenya. Weight-for-age (WAZ), length-for-age (LAZ), head circumference-for-age (HCAZ) z-scores and underweight (WAZ<−2), stunting (LAZ<−2), and microcephaly (HCAZ<−2), were compared between HEU and HUU. Correlates of growth faltering and poor growth were assessed using generalized Poisson and linear regression models.

Results:

Among 2,457 infants, 456 (19%) were HEU. Among mothers living with HIV, 64% received antiretroviral therapy and 22% were on antiretroviral prophylaxis during pregnancy. At 9-months, 72% of HEU and 98% of HUU were breastfeeding. At 6-weeks, HEU had lower mean WAZ (−0.41 vs. −0.09; p<0.001) and LAZ (−0.99 vs. −0.31; p=0.001) than HUU. Stunting was higher in HEU than HUU at 6-weeks (34% vs 18%, p<0.001) and 9-months (20% vs 10%, p<0.001). In multivariable analyses, HEU had lower mean LAZ at 6-weeks (−0.67, 95%CI: −1.07, −0.26) and 9-months (−0.57, 95%CI: −0.92, −0.21) and HEU had higher stunting prevalence (week-6 adjusted prevalence ratio [aPR]: 1.88, 95%CI: 1.35, 2.63; month-9 aPR: 2.10, 95%CI: 1.41, 3.13). HEU had lower mean head circumference (−0.49, 95%CI: −0.91, −0.07) and higher prevalence of microcephaly (aPR: 2.21, 95%CI: 1.11, 4.41) at 9-months.

Conclusion:

Despite high maternal ART coverage, HEU had poorer growth than HUU in this large population-level comparison. Optimizing breastfeeding practices in HEU may be useful to improve growth.
Subjects:

[+]

Child Female Growth Disorders HIV Infections Humans Infant Microcephaly Pregnancy Pregnancy Complications, Infectious Prevalence Prospective Studies
Source:

AIDS. 36(4):605-610
Pubmed ID:

34750290
Pubmed Central ID:

PMC8985586
Document Type:

Journal Article
Funding:

U2G PS002047/PS/NCHHSTP CDC HHSUnited States/ ; T32 AI007140/AI/NIAID NIH HHSUnited States/ ; U2GPS002047/PEPFAR/PEPFARUnited States/ ; K24 HD054314/HD/NICHD NIH HHSUnited States/ ; P30 AI027757/AI/NIAID NIH HHSUnited States/

U2G PS002047/PS/NCHHSTP CDC HHSUnited States/ ; T32 AI007140/AI/NIAID NIH HHSUnited States/ ; U2GPS002047/PEPFAR/PEPFARUnited States/ ; K24 HD054314/HD/NICHD NIH HHSUnited States/ ; P30 AI027757/AI/NIAID NIH HHSUnited States/ Less -
Place as Subject:

Kenya
Collection(s):

CDC Public Access
Main Document Checksum:

[+]

urn:sha256:54c62fc7bcd34d8eef1f914a6c349f66964fb3f312dc3c57b89dda971187bd66
Download URL:

https://stacks.cdc.gov/view/cdc/116091/cdc_116091_DS1.pdf
File Type:

	nihms-1790012.nxml	xml
	NIHMS1790012-supplement-Appendix.docx	docx

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