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. 2024 Jul:270:114018.
doi: 10.1016/j.jpeds.2024.114018. Epub 2024 Mar 19.

Growth Trajectories Over the First Year of Life Among Early-Treated Infants with Human Immunodeficiency Virus and Infants Who are Human Immunodeficiency Virus-Exposed Uninfected

Ana Barrios-Tascon  1 , Renate Strehlau  2 , Faeezah Patel  3 , Megan Burke  2 , Stephanie Shiau  4 , Yanhan Shen  5 , Stephen M Arpadi  6 , Elaine J Abrams  7 , Caroline T Tiemessen  8 , Louise Kuhn  6 ; LEOPARD study team
Affiliations

Growth Trajectories Over the First Year of Life Among Early-Treated Infants with Human Immunodeficiency Virus and Infants Who are Human Immunodeficiency Virus-Exposed Uninfected

Ana Barrios-Tascon et al. J Pediatr. 2024 Jul.

Abstract

Objective: To investigate the role of early antiretroviral therapy (ART) on growth trajectories of infants with human immunodeficiency virus (IHIV) in the first year of life.

Study design: As part of a clinical trial of early ART in Johannesburg, South Africa (2015-2018), 116 IHIV diagnosed within 48 hours of birth were started on ART as soon as possible, and 80 uninfected infants born to mothers living with HIV (IHEU) were enrolled. Both groups were followed prospectively from birth through 48 weeks and growth parameters collected. The groups were compared and risk factors for poor growth investigated, in the full cohort and among IHIV separately.

Results: IHIV had lower mean weight-for-age Z-scores (WAZ) than IHEU at 4 and 8 weeks (-1.17 [SE:0.14] vs -0.72 [0.14], P = .035 and -1.23 [0.15] vs -0.67 [0.14], P = .012). Although there was some closing of the gap over time, means remained lower in IHIV through 48 weeks. In length-for-age Z-scores (LAZ), differences widened over time and IHIV had lower Z-scores by 48 weeks (-1.41 [0.15] vs -0.80 [0.18], P = .011). Deficits in WAZ and LAZ in IHIV vs IHEU were most marked among girls. IHIV with pre-ART viral load ≥1000 copies/ml had significantly lower weight-for-length and mid-upper arm circumference Z-scores across all time points through 48 weeks.

Conclusions: IHIV on early ART had deficits in WAZ over the first 8 weeks of life and lower LAZ at 48 weeks than IHEU. Among IHIV, higher pre-ART viral load was associated with worse anthropometric indicators through 48 weeks.

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Conflict of interest statement

Declaration of Competing Interest Funding: The Latency and Early Neonatal Provision of Antiretroviral Drugs (LEOPARD) study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institute of Allergy and Infectious Disease, National Institutes of Health (U01HD080441), the South African National HIV Programme, and South African Research Chairs Initiative of the Department of Science and Innovation and National Research Foundation of South Africa (84177).

Figures

Figure 1.
Figure 1.. A. Weight for age Z-score (WAZ) B. Length for age Z-score (LAZ), C. Weight for length Z-score (WLZ) and D. Head circumference for age Z-score (HCAZ) at 4, 8, 12, 24, 36 and 48 weeks of age among infants with HIV (IHIV) and infants who are HIV-exposed uninfected (IHEU). E. Number of infants with this measurement at each time point
Abbreviations: GEE: Generalized Estimating Equations, β: parameter coefficient for HIV status adjusted for preterm birth and SE standard error.
Figure 2.
Figure 2.. Weight for age Z-score (WAZ) and Length for age Z-score (LAZ) at 4, 8, 12, 24, 36 and 48 weeks of age by sex in the whole cohort (A, B), among females only by HIV status (C, D) and among males only by HIV status (E, F).
Abbreviations: GEE: Generalized Estimating Equations, β: parameter coefficient for HIV status adjusted for preterm birth and SE standard error.
Figure 3.
Figure 3.. A. Weight for age Z-score (WAZ) B. Length for age Z-score (LAZ), C. Weight for length Z-score (WLZ) and D. Mid-upper arm circumference for age Z-score (MUACZ) at 4, 8, 12, 24, 36 and 48 weeks of age among infants with HIV (IHIV) by pre-ART viral load (VL).
Abbreviations: GEE: Generalized Estimating Equations, β: parameter coefficient for HIV status adjusted for preterm birth and SE standard error.
See this image and copyright information in PMC

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