Growth trajectories of breastfed HIV-exposed uninfected and HIV-unexposed children under conditions of universal maternal antiretroviral therapy: a prospective study

Lower Birth Weight-for-age and Length-for-age Z-scores in Infants With in-utero HIV and ART Exposure: A Prospective Study in Cape Town, South Africa

“…Our nding of lower WAZ at birth among infants who were HEU is consistent with several studies in African populations [2,3,6,8]. While some studies were conducted prior to universal maternal ART, others are similar to our cohort with lower WAZ noted in WLHIV who receive ART.…”

“…Successful scale-up of maternal antiretroviral treatment (ART) use in pregnancy has dramatically reduced infant HIV acquisition but has resulted in a large and expanding population of infants born HIV-uninfected despite in utero exposure to HIV (HIV exposed uninfected [HEU]) [2]. Several studies have shown that infants who are HEU experience poorer growth, health and survival outcomes compared with their counterparts, infants who are HIV-unexposed (HU) [2][3][4][5][6][7]. Some studies have shown that fetal growth, measured by an infant's birth weight and length may be affected by in utero antiretroviral (ARV) exposure [6,[8][9][10].…”

The impact of health programmes to prevent vertical transmission of HIV. Advances, emerging health challenges and research priorities for children exposed to or living with HIV: Perspectives from South Africa

“…However, recent data show poorer early growth of HEU children, and notably suboptimal growth and failure to catch up postnatally in HEU infants born small for gestational age compared with HIV-unexposed infants. [34] This observation suggests a fetal origin to later poor HEU child outcomes that requires further interrogation. [35] Data also show that maternal HIV infection is associated with several adverse birth outcomes such as low birthweight, preterm birth, small-for-gestational age and stillbirth.…”

“…[34] This observation suggests a fetal origin to later poor HEU child outcomes that requires further interrogation. [35] Data also show that maternal HIV infection is associated with several adverse birth outcomes such as low birthweight, preterm birth, small-for-gestational age and stillbirth. [36][37][38] Additionally, HEU children in the era of Option B+ have poorer height growth compared with weight, and therefore higher BMI, and obesity remain a concern in adolescence and adulthood (du Plessis -in press).…”

“…[39] There is also evidence that in utero exposure to maternal ART increases the risk of suboptimal birth outcomes, leading to poorer growth postnatally. [35,40] As countries adopt lifelong ART for pregnant and lactating women (WHO Option B+ policy), more women with higher CD4 counts will conceive on ART. Few data are available on these women and their children.…”