Growth patterns of infants with in- utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambia

Simple item page
dc.contributor.authorNyemba, Dorothy C.
dc.contributor.authorKalk, Emma
dc.contributor.authorVinikoor, Michael J
dc.contributor.authorMadlala, Hlengiwe P
dc.contributor.authorMubiana-Mbewe, Mwangelwa
dc.contributor.authorMzumara, Maureen
dc.contributor.authorMoore, Carolyn B
dc.contributor.authorSlogrove, Amy L
dc.contributor.authorBoulle, Andrew
dc.contributor.authorDavies, Mary-Ann
dc.contributor.authorMyer, Landon
dc.contributor.authorPowis, Kathleen
dc.date.accessioned2022-04-06T07:49:29Z
dc.date.available2022-04-06T07:49:29Z
dc.date.issued2022-01-10
dc.date.updated2022-01-16T05:06:08Z
dc.description.abstractBackground Infants born HIV-exposed yet remain uninfected (HEU) are at increased risk of poorer growth and health compared to infants born HIV-unexposed (HU). Whether maternal antiretroviral treatment (ART) in pregnancy ameliorates this risk of poorer growth is not well understood. Furthermore, whether risks are similar across high burden HIV settings has not been extensively explored. Methods We harmonized data from two prospective observational studies conducted in Cape Town, South Africa, and Lusaka, Zambia, to compare weight-for-age (WAZ), length-for-age (LAZ) and weight-for-length (WLZ) Z-scores between infants who were HEU and HU, converting infant anthropometric measures using World Health Organisation Growth Standards adjusted for age and sex. Linear mixed effects models were fit to identify risk factors for differences in anthropometrics at 6–10 weeks and 6 months by infant HIV exposures status and by timing of exposure to maternal ART, either from conception or later in gestation. Results Overall 773 mother-infant pairs were included across two countries: women living with HIV (WLHIV), 51% (n = 395) with 65% on ART at conception and 35% initiating treatment in pregnancy. In linear mixed effects models, WAZ and WLZ at 6–10 weeks were lower among infants who were HEU vs HU [β = − 0.29 (95% CI: − 0.46, − 0.12) and [β = − 0.42 (95% CI: − 0.68, − 0.16)] respectively after adjusting for maternal characteristics and infant feeding with a random intercept for country. At 6 months, LAZ was lower [β = − 0.28 CI: − 0.50, − 0.06)] among infants who were HEU, adjusting for the same variables, with no differences in WAZ and WLZ. Within cohort evaluations identified different results with higher LAZ among infants who were HEU from Zambia at 6–10 weeks, [β = + 0.34 CI: + 0.01, + 0.68)] and lower LAZ among infants who were HEU from South Africa [β = − 0.30 CI: − 0.59, − 0.01)] at 6 months, without other anthropometric differences at either site. Conclusion Infant growth trajectories differed by country, highlighting the importance of studying contextual influences on outcomes of infants who were HEU.en_US
dc.identifier.apacitationNyemba, Dorothy C., Kalk, E., Vinikoor, M. J., Madlala, H. P., Mubiana-Mbewe, M., Mzumara, M., ... Powis, K. (2022). Growth patterns of infants with in- utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambia. <i>BMC Public Health</i>, 22(1), 55. http://hdl.handle.net/11427/36277en_ZA
dc.identifier.chicagocitationNyemba, Dorothy C., Emma Kalk, Michael J Vinikoor, Hlengiwe P Madlala, Mwangelwa Mubiana-Mbewe, Maureen Mzumara, Carolyn B Moore, et al "Growth patterns of infants with in- utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambia." <i>BMC Public Health</i> 22, 1. (2022): 55. http://hdl.handle.net/11427/36277en_ZA
dc.identifier.citationNyemba, Dorothy C., Kalk, E., Vinikoor, M.J., Madlala, H.P., Mubiana-Mbewe, M., Mzumara, M., Moore, C.B. & Slogrove, A.L. et al. 2022. Growth patterns of infants with in- utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambia. <i>BMC Public Health.</i> 22(1):55. http://hdl.handle.net/11427/36277en_ZA
dc.identifier.ris TY - Journal Article AU - Nyemba, Dorothy C. AU - Kalk, Emma AU - Vinikoor, Michael J AU - Madlala, Hlengiwe P AU - Mubiana-Mbewe, Mwangelwa AU - Mzumara, Maureen AU - Moore, Carolyn B AU - Slogrove, Amy L AU - Boulle, Andrew AU - Davies, Mary-Ann AU - Myer, Landon AU - Powis, Kathleen AB - Background Infants born HIV-exposed yet remain uninfected (HEU) are at increased risk of poorer growth and health compared to infants born HIV-unexposed (HU). Whether maternal antiretroviral treatment (ART) in pregnancy ameliorates this risk of poorer growth is not well understood. Furthermore, whether risks are similar across high burden HIV settings has not been extensively explored. Methods We harmonized data from two prospective observational studies conducted in Cape Town, South Africa, and Lusaka, Zambia, to compare weight-for-age (WAZ), length-for-age (LAZ) and weight-for-length (WLZ) Z-scores between infants who were HEU and HU, converting infant anthropometric measures using World Health Organisation Growth Standards adjusted for age and sex. Linear mixed effects models were fit to identify risk factors for differences in anthropometrics at 6–10 weeks and 6 months by infant HIV exposures status and by timing of exposure to maternal ART, either from conception or later in gestation. Results Overall 773 mother-infant pairs were included across two countries: women living with HIV (WLHIV), 51% (n = 395) with 65% on ART at conception and 35% initiating treatment in pregnancy. In linear mixed effects models, WAZ and WLZ at 6–10 weeks were lower among infants who were HEU vs HU [β = − 0.29 (95% CI: − 0.46, − 0.12) and [β = − 0.42 (95% CI: − 0.68, − 0.16)] respectively after adjusting for maternal characteristics and infant feeding with a random intercept for country. At 6 months, LAZ was lower [β = − 0.28 CI: − 0.50, − 0.06)] among infants who were HEU, adjusting for the same variables, with no differences in WAZ and WLZ. Within cohort evaluations identified different results with higher LAZ among infants who were HEU from Zambia at 6–10 weeks, [β = + 0.34 CI: + 0.01, + 0.68)] and lower LAZ among infants who were HEU from South Africa [β = − 0.30 CI: − 0.59, − 0.01)] at 6 months, without other anthropometric differences at either site. Conclusion Infant growth trajectories differed by country, highlighting the importance of studying contextual influences on outcomes of infants who were HEU. DA - 2022-01-10 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Public Health KW - HIV-exposed uninfected KW - HIV-unexposed KW - antiretroviral therapy KW - weight-for-age KW - length-for-age KW - South Africa KW - Zambia LK - https://open.uct.ac.za PY - 2022 T1 - Growth patterns of infants with in- utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambia TI - Growth patterns of infants with in- utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambia UR - http://hdl.handle.net/11427/36277 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12889-021-12476-z
dc.identifier.urihttp://hdl.handle.net/11427/36277
dc.identifier.vancouvercitationNyemba Dorothy C, Kalk E, Vinikoor MJ, Madlala HP, Mubiana-Mbewe M, Mzumara M, et al. Growth patterns of infants with in- utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambia. BMC Public Health. 2022;22(1):55. http://hdl.handle.net/11427/36277.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentCentre for Infectious Disease Epidemiology and Research (CIDER)en_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Public Healthen_US
dc.source.journalissue1en_US
dc.source.journalvolume22en_US
dc.source.pagination55en_US
dc.source.urihttps://bmcpublichealth.biomedcentral.com/
dc.subjectHIV-exposed uninfecteden_US
dc.subjectHIV-unexposeden_US
dc.subjectantiretroviral therapyen_US
dc.subjectweight-for-ageen_US
dc.subjectlength-for-ageen_US
dc.subjectSouth Africaen_US
dc.subjectZambiaen_US
dc.titleGrowth patterns of infants with in- utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambiaen_US
dc.typeJournal Articleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
12889_2021_Article_12476.pdf
Size:
1.2 MB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
0 B
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Journal Articles