HIV-Exposed, Uninfected Infants in Uganda Experience Poorer Growth and Body Composition Trajectories than HIV-Unexposed Infants

Abstract

Abstract Objectives To determine if HIV-exposed and -uninfected (HEU) infants whose mothers received Option B + have higher odds of experiencing suboptimal growth trajectories than HIV-unexposed uninfected (HUU) infants. Methods Anthropometric measures were taken on 238 infants (HEU = 86) at 1 week and 1,3,6,9, and 12 months. Latent class growth mixture modeling was used to develop trajectories for length-for-age z-scores, weight-for-length z-scores, MUAC, sum of skinfolds, and arm fat area. Multinomial logistic models were built to predict odds of class membership by HIV and food security status, controlling for socioeconomic factors. Results HEU infants had greater odds of being in the shortest two classes (OR = 4.30, P = 0.01 and OR = 10.70, P < 0.01) and lower odds of being in smallest arm fat area class (OR = 0.26, P = 0.01) relative to HUU infants. Food insecurity was associated with a smaller increase in the odds that HEU infants were in the second shortest class (OR interaction = 0.83, P = 0.03). Only among HEU, food insecurity increased odds of being in the lowest sum of skinfolds class (OR interaction = 3.80, P = 0.01). Conclusions HEU experience suboptimal growth patterns compared to unexposed infants. HEU infants are differentially affected by food insecurity. The mechanisms which drive these differences and successful strategies for counteracting any potential harm need further investigation. Funding Sources CL was supported by the Royster Society of Fellows. Data collection was supported by the Feed the Future Innovation Laboratory for Nutrition, which is funded by the United States Agency for International Development (USAID) and based at Tufts University (USAID OAA-L-10- 00006), and by a seed grant for collaborations between Cornell University– Ithaca and Weill Cornell Medical College faculty. EMW was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K99/R00 HD086304), the National Institute of Diabetes and Digestive and Kidney Diseases (T32DK091227 and T32DK007559), and PepsiCo Global R + D (unrestricted grant to support research in maternal and child health). SLY was supported by the National Institute of Mental Health (K01MH098902). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.