TY - JOUR
T1 - Growth at 2 years of age in HIV-exposed uninfected children in the United States by trimester of maternal antiretroviral initiation
AU - the Pediatric HIV/AIDS Cohort Study
AU - Jacobson, Denise L.
AU - Patel, Kunjal
AU - Williams, Paige L.
AU - Geffner, Mitchell E.
AU - Siberry, George K.
AU - DiMeglio, Linda A.
AU - Crain, Marilyn J.
AU - Mirza, Ayesha
AU - Chen, Janet S.
AU - McFarland, Elizabeth
AU - Kacanek, Deborah
AU - Silio, Margarita
AU - Rich, Kenneth
AU - Borkowsky, William
AU - Van Dyke, Russell B.
AU - Miller, Tracie L.
AU - Shearer, William
AU - Paul, Mary
AU - Cooper, Norma
AU - Harris, Lynette
AU - Purswani, Murli
AU - Stuard, Emma
AU - Cintron, Anna
AU - Puga, Ana
AU - Cooley, Dia
AU - Patton, Doyle
AU - Leon, Deyana
AU - Yogev, Ram
AU - Sanders, Margaret Ann
AU - Malee, Kathleen
AU - Hunter, Scott
AU - Deygoo, Sandra
AU - Rozelman, Helen
AU - Knapp, Katherine
AU - Allison, Kim
AU - Wilkins, Megan
AU - Acevedo-Flores, Midnela
AU - Angeli-Nieves, Lourdes
AU - Olivera, Vivian
AU - Mendez, Hermann
AU - Dennie, Ava
AU - Bewley, Susan
AU - Craig, Karen
AU - Sirois, Patricia
AU - Beatty, Newana
AU - Huldtquist, Julie
AU - Spector, Stephen
AU - Manning, Jean
AU - Nichols, Sharon
AU - Barr, Emily
N1 - Funding Information:
This work was supported by the National Institutes of Health. The Pediatric HIV/AIDS Cohort Study (PHACS) was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development with cofunding from the National Institute on Drug Abuse, the National Institute of Allergy and Infectious Diseases, the Office of AIDS Research, the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke, the National Institute on Deafness and Other Communication Disorders, the National Heart Lung and Blood Institute, the National Institute of Dental and Craniofacial Research and the National Institute on Alcohol Abuse and Alcoholism, through cooperative agreements with the Harvard University School of Public Health (HD052102, 3 U01 HD052102-05S1, 3 U01 HD052102-06S3) (Principal Investigator: George Seage; Project Director: Julie Alperen) and the Tulane University School of Medicine (HD052104, 3U01HD052104-06S1) (Principal Investigator: Russell Van Dyke; Co-Principal Investigator: Kenneth Rich; Project Director: Patrick Davis).
Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Background: Abnormal childhood growth may affect future health. Maternal tenofovir (TFV) use was associated with lower body length and head circumference at 1 year of age in HIV-exposed uninfected (HEU) US children. Methods: We studied 509 HEU children in the US-based Surveillance Monitoring of Antiretroviral Therapy Toxicities cohort whose HIV-infected mothers were not using antiretrovirals at the last menstrual period and began combination antiretroviral therapy (cART) in pregnancy (cART initiators). We examined adjusted associations between antiretrovirals and Centers for Disease Control 2000 growth Z scores at 2 years of age within trimester of cART initiation: weight (weight Z score), length (length Z score), weight-for-length [weight-for-length Z score (WFLZ)], triceps skinfold Z score (TSFZ) and head circumference (head circumference Z score). Results: Mothers mean age was 28.6 years; 57% were black non-Hispanic and 19% delivered at <37 weeks gestation. At 2 years, mean weight Z score, length Z score, WFLZ and head circumference Z score were above average (P < 0.05), whereas TSFZ (P = 0.57) did not differ from average. WFLZ was >1.64 standard deviation (SD) (>95th percentile) in 13%. Among children of first-trimester cART initiators, TFV+emtricitabine-exposed children had slightly higher mean WFLZ (0.45 SD; 95% confidence interval: -0.10 to 1.00) and lower TSFZ (-0.55 SD; 95% confidence interval: -1.07 to -0.02) compared with zidovudine+lamivudine-exposed children. TSFZ was lower in those exposed to boosted protease inhibitors. In contrast, growth in children of second trimester cART initiators did not differ by antiretroviral exposures. Conclusion: Growth was above average in HEU; 13% were obese. Maternal TFV use was not associated with lower length or head circumference at 2 years of age, as hypothesized, but may be related to greater weight among those exposed to cART early in pregnancy.
AB - Background: Abnormal childhood growth may affect future health. Maternal tenofovir (TFV) use was associated with lower body length and head circumference at 1 year of age in HIV-exposed uninfected (HEU) US children. Methods: We studied 509 HEU children in the US-based Surveillance Monitoring of Antiretroviral Therapy Toxicities cohort whose HIV-infected mothers were not using antiretrovirals at the last menstrual period and began combination antiretroviral therapy (cART) in pregnancy (cART initiators). We examined adjusted associations between antiretrovirals and Centers for Disease Control 2000 growth Z scores at 2 years of age within trimester of cART initiation: weight (weight Z score), length (length Z score), weight-for-length [weight-for-length Z score (WFLZ)], triceps skinfold Z score (TSFZ) and head circumference (head circumference Z score). Results: Mothers mean age was 28.6 years; 57% were black non-Hispanic and 19% delivered at <37 weeks gestation. At 2 years, mean weight Z score, length Z score, WFLZ and head circumference Z score were above average (P < 0.05), whereas TSFZ (P = 0.57) did not differ from average. WFLZ was >1.64 standard deviation (SD) (>95th percentile) in 13%. Among children of first-trimester cART initiators, TFV+emtricitabine-exposed children had slightly higher mean WFLZ (0.45 SD; 95% confidence interval: -0.10 to 1.00) and lower TSFZ (-0.55 SD; 95% confidence interval: -1.07 to -0.02) compared with zidovudine+lamivudine-exposed children. TSFZ was lower in those exposed to boosted protease inhibitors. In contrast, growth in children of second trimester cART initiators did not differ by antiretroviral exposures. Conclusion: Growth was above average in HEU; 13% were obese. Maternal TFV use was not associated with lower length or head circumference at 2 years of age, as hypothesized, but may be related to greater weight among those exposed to cART early in pregnancy.
KW - Early childhood growth
KW - HIV-exposed uninfected children
KW - Maternal antiretroviral therapy
KW - Obesity
KW - Tenofovir
KW - Trimester of pregnancy
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U2 - 10.1097/INF.0000000000001387
DO - 10.1097/INF.0000000000001387
M3 - Article
AN - SCOPUS:84992745690
SN - 0891-3668
VL - 36
SP - 189
EP - 197
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
IS - 2
ER -