Child Growth According to Maternal and Child HIV Status in Zimbabwe

Omoni, Adetayo O.; Ntozini, Robert; Evans, Ceri; Prendergast, Andrew J.; Moulton, Lawrence H.; Christian, Parul; Humphrey, Jean H.

doi:10.1097/inf.0000000000001574

Cited by 70 publications

(74 citation statements)

References 42 publications

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“…These infants did not have the elevated WLZ observed in our population. In Zimbabwe before the availability of ART, HEU infants had higher risk of stunting and wasting, but growth trajectories in LAZ and WLZ were not meaningfully different from unexposed infants over the first 2 years of life (Omoni et al, ). HEU infant WLZ was lower than unexposed infants WLZ in this setting, whereas we find that HEU infant WLZ is higher than the average WLZ of Rwanda as a whole.…”

Section: Discussionmentioning

confidence: 99%

“…Option B+ was quickly adopted in Rwanda, where it was implemented in 2013. Before Option B+ and the WHO recommendation for continued breastfeeding of HEU infants, HEU infants were at higher risk of impaired growth than their unexposed counterparts (Evans et al, ; Lartey et al, ; Omoni et al, ). The prevalence of risk factors for poor growth associated with HIV is expected to decrease with the adoption of Option B+ and the WHO recommendation for continued breastfeeding among HIV‐positive mothers in low‐resource settings (Evans et al, ; WHO, ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Determinants of growth in HIV‐exposed and HIV‐uninfected infants in the Kabeho Study

Lane

Bobrow

Ndatimana³

et al. 2019

Maternal & Child Nutrition

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HIV-exposed and HIV-uninfected (HEU) infants may be at increased risk of poor health and growth outcomes. We characterized infant growth trajectories in a cohort of HEU infants to identify factors associated with healthy growth. HIV-positive women participating in prevention of mother-to-child HIV transmission programmes in Kigali, Rwanda, were followed until their infants were 2 years old. Infant anthropometrics were regularly collected. Latent class analysis was used to categorize infant growth trajectories. Multiple logistic regression was used to estimate the odds of infants belonging to each growth trajectory class. On average, this population of HEU infants had moderate linear growth faltering, but only modest faltering in weight, resulting in mean weight-for-length z-score (WLZ) above the World Health Organization (WHO) median. Mean WLZ was 0.53, and mean length-for-age z-score (LAZ) was −1.14 over the first 2 years of life. We identified four unique WLZ trajectories and seven trajectories in LAZ. Low neonatal weight-for-age and a high rate of illness increased the likelihood that infants were in the lightest WLZ class. Shorter mothers were more likely to have infants with linear growth faltering. Female infants who were older at the end of exclusive breastfeeding were more likely to be in the second tallest LAZ class. In conclusion, the current WHO recommendations of Option B+ and extended breastfeeding may induce higher WLZ and lower LAZ early in infancy. However, there is considerable heterogeneity in growth patterns that is obscured by simply analysing average growth trends, necessitating the analysis of growth in subpopulations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Determinants of growth in HIV‐exposed and HIV‐uninfected infants in the Kabeho Study

Lane

Bobrow

Ndatimana³

et al. 2019

Maternal & Child Nutrition

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“…We found that infants born to mothers with more than primary education or of taller stature experienced less linear growth decline compared with those with less educated and shorter mothers. Maternal education is consistently associated with improved childhood growth in SSA (Omoni et al, ; Webb et al, ). Among HIV‐infected mothers, those with more schooling may have greater knowledge regarding health care seeking, and adherence to medical advice, each of which may help to protect the health of the mother and her infant.…”

Section: Discussionmentioning

confidence: 99%

Birth size and early pneumonia predict linear growth among HIV‐exposed uninfected infants

Deichsel

Pavlinac

Richardson

et al. 2019

Maternal & Child Nutrition

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Stunting remains a global health priority, particularly in sub‐Saharan Africa. Identifying determinants of linear growth in HIV‐exposed uninfected (HEU) infants can inform interventions to prevent stunting in this vulnerable population. HIV‐infected mothers and their uninfected infants were followed monthly from pregnancy to 12‐month post‐partum in Nairobi, Kenya. Mixed‐effects models estimated the change in length‐for‐age z‐score (LAZ) from birth to 12 months by environmental, maternal, and infant characteristics. Multivariable models included factors univariately associated with LAZ. Among 372 HEU infants, mean LAZ decreased from −0.54 (95% confidence interval [CI] [−0.67, −0.41]) to −1.09 (95% CI [−1.23, −0.96]) between 0 and 12 months. Declines in LAZ were associated with crowding (≥2 persons per room; adjusted difference [AD] in 0–12 month change: −0.46; 95% CI [−0.87, −0.05]), use of a pit latrine versus a flush toilet (AD: −0.29; 95% CI [−0.57, −0.02]), and early infant pneumonia (AD: −1.14; 95% CI [−1.99, −0.29]). Infants with low birthweight (<2,500 g; AD: 1.08; 95% CI [0.40, 1.76]) and birth stunting (AD: 1.11; 95% CI [0.45, 1.78]) experienced improved linear growth. By 12 months of age, 46 infants were stunted, of whom 11 (24%) were stunted at birth. Of the 34 infants stunted at birth with an available 12‐month LAZ, 68% were not stunted at 12 months. Some low birthweight and birth‐stunted HEU infants had significant linear growth recovery. Early infant pneumonia and household environment predicted poor linear growth and may identify a subgroup of HEU infants for whom to provide growth‐promoting interventions.

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“…In 2019, 15.2 million children were CHEU worldwide, thus exposed to HIV and ARV [ 6 ]. Many unfavourable health outcomes have been reported in CHEU such as metabolic disorders [ 7 , 8 ], increased infectious disease morbidity and higher mortality [ 9 , 10 , 11 , 12 ], impaired growth [ 13 , 14 , 15 , 16 , 17 , 18 ], neurodevelopmental delays [ 17 , 19 , 20 , 21 ], altered immunity [ 10 , 22 , 23 , 24 , 25 , 26 ], and mitochondrial toxicity in comparison to never HIV-exposed children [ 27 , 28 , 29 , 30 ]. Taken together, this prompted Powis and Siberry to advocate for the long-term follow up of CHEU irrespective of their HIV/ARV exposures [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

Mitochondrial DNA Parameters in Blood of Infants Receiving Lopinavir/Ritonavir or Lamivudine Prophylaxis to Prevent Breastfeeding Transmission of HIV-1

Monnin

Nagot

Peries

et al. 2020

JCM

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Children who are human immunodeficiency virus (HIV)-exposed but uninfected (CHEU) accumulate maternal HIV and antiretroviral exposures through pregnancy, postnatal prophylaxis, and breastfeeding. Here, we compared the dynamics of mitochondrial DNA (mtDNA) parameters in African breastfed CHEU receiving lopinavir/ritonavir (LPV/r) or lamivudine (3TC) pre-exposure prophylaxis during the first year of life. The number of mtDNA copies per cell (MCN) and the proportion of deleted mtDNA (MDD) were assessed at day 7 and at week 50 post-delivery (PrEP group). mtDNA depletion was defined as a 50% or more decrease from the initial value, and mtDNA deletions was the detection of mtDNA molecules with large DNA fragment loss. We also performed a sub-analysis with CHEU who did not receive a prophylactic treatment in South Africa (control group). From day seven to week 50, MCN decreased with a median of 41.7% (interquartile range, IQR: 12.1; 64.4) in the PrEP group. The proportion of children with mtDNA depletion was not significantly different between the two prophylactic regimens. Poisson regressions showed that LPV/r and 3TC were associated with mtDNA depletion (reference: control group; LPV/r: PR = 1.75 (CI95%: 1.15–2.68), p < 0.01; 3TC: PR = 1.54 (CI95%: 1.00–2.37), p = 0.05). Moreover, the proportion of children with MDD was unexpectedly high before randomisation in both groups. Long-term health impacts of these mitochondrial DNA parameters should be investigated further for both CHEU and HIV-infected children receiving LPV/r- or 3TC- based regimens.

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Child Growth According to Maternal and Child HIV Status in Zimbabwe

Cited by 70 publications

References 42 publications

Determinants of growth in HIV‐exposed and HIV‐uninfected infants in the Kabeho Study

Determinants of growth in HIV‐exposed and HIV‐uninfected infants in the Kabeho Study

Birth size and early pneumonia predict linear growth among HIV‐exposed uninfected infants

Mitochondrial DNA Parameters in Blood of Infants Receiving Lopinavir/Ritonavir or Lamivudine Prophylaxis to Prevent Breastfeeding Transmission of HIV-1

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