July 26, 2019
2 min read

HIV-exposed, uninfected infants catch up in size by early childhood

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Infants born to mothers with HIV but are not infected with the virus tend to be smaller at birth. However, research published in Clinical Infectious Diseases demonstrates that many HIV-exposed and uninfected, or HEU, children catch up in weight and length by early childhood.

“As [combination ART (cART)] is now recommended and implemented globally to all people living with HIV, an increasing number of women living with HIV will either conceive or initiate cART during pregnancy, resulting in a growing population of HEU children,” Ellen Moseholm Larsen, a PhD student in the department of infectious diseases at Copenhagen University Hospital, and colleagues wrote. “Exposures to HIV and cART in utero may have adverse effects on infant development and growth.”

The researchers examined all singleton HEU births (n = 485) reported in Denmark between 2000 and 2016 in a nationwide register. All HEU children were matched with singleton controls who were not exposed to HIV (n = 2,495).

Larsen and colleagues observed that HEU children were smaller compared with unexposed children at birth. They calculated that the adjusted difference in mean weight-for-age (WAZ) z-score was –0.29 (95% CI, –0.46 to –0.12; P < .001) and –0.51 for length-for-age (LAZ) z-score (95% CI, –0.71 to –0.31; P < .001).

Infant holding hand 
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The researchers observed that as HEU infants aged, their WAZ and LAZ improved. By the time HEU infants were aged 14 days, there was no statistically significant difference between WAZ z-scores (–0.13; 95% CI, –0.27 to 0.01; P = .07), nor was there any statistically significant difference in LAZ z-scores by age 6 months (–0.15; 95% CI, –0.32 to 0.02; P = .08).

Larsen and colleagues wrote that none of the HEU children were breastfed, which could explain differences in growth related to weight gain in early life.

“Low birth weight and rapid catch-up growth in early childhood may have a negative impact long-term on health, such as increased risk for obesity, insulin resistance and increased risk for cardiovascular disease,” the researchers wrote. “Thus, our finding that HEU children are smaller at birth, but seem to catch up during the first year of life, may have implications into adulthood. Moreover, any possible difference in the timing of catch-up growth between HEU and HIV-unexposed children should be investigated in further studies.” – by Katherine Bortz

Disclosures: Larsen reports receiving grants from the Novo Nordisk Foundation outside of the submitted work. Please see the study for all other authors’ relevant financial disclosures.