Growth of HIV-exposed uninfected infants in the first 6 months of life in South Africa: The IeDEA-SA collaboration

 

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dc.contributor.author Morden, Erna en_ZA
dc.contributor.author Technau, Karl-Günter en_ZA
dc.contributor.author Giddy, Janet en_ZA
dc.contributor.author Maxwell, Nicola en_ZA
dc.contributor.author Keiser, Olivia en_ZA
dc.contributor.author Davies, Mary-Ann en_ZA
dc.date.accessioned 2016-04-13T12:38:46Z
dc.date.available 2016-04-13T12:38:46Z
dc.date.issued 2016 en_ZA
dc.identifier.citation Morden, E., Technau, K. G., Giddy, J., Maxwell, N., Keiser, O., & Davies, M. A. (2016). Growth of HIV-exposed uninfected infants in the first 6 months of life in South Africa: The IeDEA-SA collaboration. PLoS One, 11(4), e0151762. doi:10.1371/journal.pone.0151762 en_ZA
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0151762 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/18861
dc.description.abstract BACKGROUND: HIV-exposed uninfected (HEU) infants are a growing population in sub-Saharan Africa especially with the increasing coverage of more effective prevention of mother-to-child transmission (PMTCT) antiretroviral therapy regimens. This study describes the characteristics of South African HEU infants, investigates factors impacting birth weight and assesses their growth within the first 28 weeks of life. METHODS: This is a retrospective cohort based on routine clinical data from two South African PMTCT programmes. Data were collected between 2007 and 2013. Linear regression assessed factors affecting birth weight-for-age z-scores (WAZ) while growth (longitudinal WAZ) was assessed using mixed effects models. RESULTS: We assessed the growth of 2621 HEU infants (median birth WAZ was -0.65 (IQR -1.46; 0.0) and 51% were male). The feeding modalities practised were as follows: 0.5% exclusive breastfeeding, 7.9% breastfeeding with unknown exclusivity, 0.08% mixed breastfeeding and 89.2% formula feeding. Mothers with CD4 <200 cells/μl delivered infants with a lower birth WAZ (adjusted ß -0.253 [95% CI -0.043; -0.072], p = 0.006) compared to mothers with aCD4 ≥500 cells/μl. Similarly, mothers who did not receive antiretroviral drugs delivered infants with a lower birth WAZ (adjusted ß -0.39 [95% CI -0.67; -0.11], p = 0.007) compared to mothers who received antenatal antiretrovirals. Infants with a birth weight <2 500g (ß 0.070 [95% CI 0.061; 0.078], p <0.0001) experienced faster growth within the first 28 weeks of life compared to infants with a birth weight ≥2 500g. Infants with any breastfeeding exposure experienced slower longitudinal growth compared to formula fed infants (adjusted ß -0.012 [95% CI 0.021; -0.003], p = 0.011). CONCLUSION: Less severe maternal disease and the use of antiretrovirals positively impacts birth weight in this cohort of South African HEU infants. Formula feeding was common with breastfed infants experiencing marginally slower longitudinal growth. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Infants en_ZA
dc.subject.other Birth weight en_ZA
dc.subject.other Antiretrovirals en_ZA
dc.subject.other Antiretroviral therapy en_ZA
dc.subject.other Breast feeding en_ZA
dc.subject.other Labor and delivery en_ZA
dc.subject.other Linear regression analysis en_ZA
dc.subject.other Cell cycle and cell division en_ZA
dc.title Growth of HIV-exposed uninfected infants in the first 6 months of life in South Africa: The IeDEA-SA collaboration en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2016 Morden et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Public Health and Family Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Morden, E., Technau, K., Giddy, J., Maxwell, N., Keiser, O., & Davies, M. (2016). Growth of HIV-exposed uninfected infants in the first 6 months of life in South Africa: The IeDEA-SA collaboration. <i>PLoS One</i>, http://hdl.handle.net/11427/18861 en_ZA
dc.identifier.chicagocitation Morden, Erna, Karl-Günter Technau, Janet Giddy, Nicola Maxwell, Olivia Keiser, and Mary-Ann Davies "Growth of HIV-exposed uninfected infants in the first 6 months of life in South Africa: The IeDEA-SA collaboration." <i>PLoS One</i> (2016) http://hdl.handle.net/11427/18861 en_ZA
dc.identifier.vancouvercitation Morden E, Technau K, Giddy J, Maxwell N, Keiser O, Davies M. Growth of HIV-exposed uninfected infants in the first 6 months of life in South Africa: The IeDEA-SA collaboration. PLoS One. 2016; http://hdl.handle.net/11427/18861. en_ZA
dc.identifier.ris TY - Journal Article AU - Morden, Erna AU - Technau, Karl-Günter AU - Giddy, Janet AU - Maxwell, Nicola AU - Keiser, Olivia AU - Davies, Mary-Ann AB - BACKGROUND: HIV-exposed uninfected (HEU) infants are a growing population in sub-Saharan Africa especially with the increasing coverage of more effective prevention of mother-to-child transmission (PMTCT) antiretroviral therapy regimens. This study describes the characteristics of South African HEU infants, investigates factors impacting birth weight and assesses their growth within the first 28 weeks of life. METHODS: This is a retrospective cohort based on routine clinical data from two South African PMTCT programmes. Data were collected between 2007 and 2013. Linear regression assessed factors affecting birth weight-for-age z-scores (WAZ) while growth (longitudinal WAZ) was assessed using mixed effects models. RESULTS: We assessed the growth of 2621 HEU infants (median birth WAZ was -0.65 (IQR -1.46; 0.0) and 51% were male). The feeding modalities practised were as follows: 0.5% exclusive breastfeeding, 7.9% breastfeeding with unknown exclusivity, 0.08% mixed breastfeeding and 89.2% formula feeding. Mothers with CD4 <200 cells/μl delivered infants with a lower birth WAZ (adjusted ß -0.253 [95% CI -0.043; -0.072], p = 0.006) compared to mothers with aCD4 ≥500 cells/μl. Similarly, mothers who did not receive antiretroviral drugs delivered infants with a lower birth WAZ (adjusted ß -0.39 [95% CI -0.67; -0.11], p = 0.007) compared to mothers who received antenatal antiretrovirals. Infants with a birth weight <2 500g (ß 0.070 [95% CI 0.061; 0.078], p <0.0001) experienced faster growth within the first 28 weeks of life compared to infants with a birth weight ≥2 500g. Infants with any breastfeeding exposure experienced slower longitudinal growth compared to formula fed infants (adjusted ß -0.012 [95% CI 0.021; -0.003], p = 0.011). CONCLUSION: Less severe maternal disease and the use of antiretrovirals positively impacts birth weight in this cohort of South African HEU infants. Formula feeding was common with breastfed infants experiencing marginally slower longitudinal growth. DA - 2016 DB - OpenUCT DO - 10.1371/journal.pone.0151762 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 T1 - Growth of HIV-exposed uninfected infants in the first 6 months of life in South Africa: The IeDEA-SA collaboration TI - Growth of HIV-exposed uninfected infants in the first 6 months of life in South Africa: The IeDEA-SA collaboration UR - http://hdl.handle.net/11427/18861 ER - en_ZA


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.