BACKGROUND:: Growth failure is common among HIV-infected infants, but there are limited data on the effects of HIV exposure or timing of HIV acquisition on growth. METHODS:: 14110 infants were enrolled in the ZVITAMBO trial in Zimbabwe before the availability of antiretroviral therapy (ART) or co-trimoxazole. Anthropometric measurements were taken from birth through 12-24 months of age. Growth outcomes were compared between 5 groups of children: HIV-infected in utero (IU), intrapartum (IP) or postnatally (PN); HIV-exposed uninfected (HEU); and HIV-unexposed. RESULTS:: Growth failure was common across all groups of children. Compared to HIV-unexposed children, IU, IP and PN-infected children had significantly lower length-for-age and weight-for-length Z-scores throughout the first two years of life. At 12 months, odds ratios for stunting were higher in IU infants (6.25, 95%CI 4.20, 9.31) and IP infants (4.76, 95%CI 3.58, 6.33) than PN infants (1.70, 95%CI 1.16, 2.47). Compared to HIV-unexposed infants, HEU infants at 12 months had odds ratios for stunting of 1.23 (95%CI 1.08, 1.39) and wasting of 1.56 (95%CI 1.22, 2.00). CONCLUSIONS:: HIV-infected infants had very high rates of growth failure during the first 2 years of life, particularly if infected in utero or intrapartum, highlighting the importance of early infant diagnosis and ART. HEU infants had poorer growth than HIV-unexposed infants in the first 12 months of life.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Microbiology (medical)
- Infectious Diseases