Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Child Growth According to Maternal and Child HIV Status in Zimbabwe

TitleChild Growth According to Maternal and Child HIV Status in Zimbabwe
Publication TypeJournal Article
Year of Publication2017
AuthorsOmoni, AO, Ntozini, R, Evans, C, Prendergast, AJ, Moulton, LH, Christian, PS, Humphrey, JH
JournalPediatr Infect Dis J
Date PublishedFeb 13
ISBN Number1532-0987 (Electronic)0891-3668 (Linking)
Accession Number28198792

BACKGROUND: Growth failure is common among HIV-infected infants, but there are limited data on the effects of HIV exposure or timing of HIV acquisition on growth. METHODS: 14110 infants were enrolled in the ZVITAMBO trial in Zimbabwe before the availability of antiretroviral therapy (ART) or co-trimoxazole. Anthropometric measurements were taken from birth through 12-24 months of age. Growth outcomes were compared between 5 groups of children: HIV-infected in utero (IU), intrapartum (IP) or postnatally (PN); HIV-exposed uninfected (HEU); and HIV-unexposed. RESULTS: Growth failure was common across all groups of children. Compared to HIV-unexposed children, IU, IP and PN-infected children had significantly lower length-for-age and weight-for-length Z-scores throughout the first two years of life. At 12 months, odds ratios for stunting were higher in IU infants (6.25, 95%CI 4.20, 9.31) and IP infants (4.76, 95%CI 3.58, 6.33) than PN infants (1.70, 95%CI 1.16, 2.47). Compared to HIV-unexposed infants, HEU infants at 12 months had odds ratios for stunting of 1.23 (95%CI 1.08, 1.39) and wasting of 1.56 (95%CI 1.22, 2.00). CONCLUSIONS: HIV-infected infants had very high rates of growth failure during the first 2 years of life, particularly if infected in utero or intrapartum, highlighting the importance of early infant diagnosis and ART. HEU infants had poorer growth than HIV-unexposed infants in the first 12 months of life.