Decreased growth among antiretroviral drug and HIV-exposed uninfected versus unexposed children in Malawi and Uganda.
AIDS
; 34(2): 215-225, 2020 02 01.
Article
em En
| MEDLINE
| ID: mdl-31634154
ABSTRACT
OBJECTIVE:
To compare growth among antiretroviral drug and maternal HIV-exposed uninfected (AHEU) versus age-matched and sex-matched HIV-unexposed uninfected (HUU) children.DESIGN:
Prospective cohort of AHEU children identified from the PROMISE trial (NCT01061151 clinicaltrials.gov registry) and age-matched and sex-matched HUU controls from child-wellness clinics, enrolled (September 2013 to October 2014) in Malawi and Uganda.METHODS:
Weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), and head-circumference-for-age (HCAZ) z-scores were derived at 12 months and 24 months of age. Wilcoxon Rank-Sum and Fisher's exact tests were used for unadjusted exposure group comparisons. Generalized Estimating Equations models estimated adjusted relative risks (aRR) for poor growth outcomes.RESULTS:
Overall, 471 (50.5%) AHEU and 462 (49.5%) HUU children were assessed. Ugandan AHEU compared with HUU children had significantly lower mean LAZ (Pâ<â0.001) and WAZ (Pâ<â0.001) at 12 and 24 months of age and HCAZ (Pâ=â0.016) at 24 months, with similar but not significant differences among Malawian AHEU and HUU children. The risk of stunting (more than two standard deviations below the WHO population LAZ median) was increased among AHEU versus HUU children aRRâ=â2.13 (95% confidence interval (CI) 1.36-3.33), Pâ=â0.001 at 12 months, and aRRâ=â1.67 (95% CI 1.16-2.41), Pâ=â0.006 at 24 months of age in Uganda; and aRRâ=â1.32 (95% CI 1.10-1.66), Pâ=â0.018, at 24 months of age in Malawi. The risk of HCAZ below WHO median was increased among AHEU versus HUU children at 24 months of age, aRRâ=â1.35 (95% CI 1.02-1.79), Pâ=â0.038 in Uganda; and aRRâ=â1.35 (95% CI 0.91-2.02), Pâ=â0.139 in Malawi.CONCLUSION:
Perinatal exposures to maternal HIV and antiretroviral drugs were associated with lower LAZ (including stunting), WAZ and HCAZ at 24 months of age compared with HUU children.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Complicações Infecciosas na Gravidez
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Infecções por HIV
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Transmissão Vertical de Doenças Infecciosas
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Antirretrovirais
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Crescimento e Desenvolvimento
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Child, preschool
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Female
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Humans
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Infant
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Male
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Pregnancy
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article