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.authorMorden, Ernaen_ZA
dc.contributor.authorTechnau, Karl-Günteren_ZA
dc.contributor.authorGiddy, Janeten_ZA
dc.contributor.authorMaxwell, Nicolaen_ZA
dc.contributor.authorKeiser, Oliviaen_ZA
dc.contributor.authorDavies, Mary-Annen_ZA
dc.date.accessioned2016-04-13T12:38:46Z
dc.date.available2016-04-13T12:38:46Z
dc.date.issued2016en_ZA
dc.description.abstractBACKGROUND: 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.identifier.apacitationMorden, 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/11427/18861en_ZA
dc.identifier.chicagocitationMorden, 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/11427/18861en_ZA
dc.identifier.citationMorden, 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.0151762en_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
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0151762en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/18861
dc.identifier.vancouvercitationMorden 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.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis 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.holder© 2016 Morden et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherInfantsen_ZA
dc.subject.otherBirth weighten_ZA
dc.subject.otherAntiretroviralsen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherBreast feedingen_ZA
dc.subject.otherLabor and deliveryen_ZA
dc.subject.otherLinear regression analysisen_ZA
dc.subject.otherCell cycle and cell divisionen_ZA
dc.titleGrowth of HIV-exposed uninfected infants in the first 6 months of life in South Africa: The IeDEA-SA collaborationen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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