Post‐natal growth among HIV‐exposed children: a cross‐study comparison

Abstract

Infants of HIV-infected mothers are born stunted (low LAZ) but patterns of post-natal growth are not consistent among HIV-exposed infants across studies. We compared anthropometric data from predominantly non-breastfed HIV-exposed children age 0–23 mo in Port-au-Prince, Haiti (2007–09) to published data from predominantly breastfed infants of HIV-infected mothers in Tanzania (1995–97) and Zambia (2001–06). Based on 3366 observations from 458 HIV-negative Haitian children, mean LAZ (SD) was −1.31 (1.64) at birth increasing to −0.53 (1.38) at 6 mo then falling steadily to −1.01 (1.31) by 18 mo (WHO 2006 Std). In contrast, breastfed HIV-negative infants in Dar es Salaam were less stunted at birth but immediately declined in LAZ through 24 mo. Breastfed HIV-negative infants in Zambia were born at similar LAZ to Haitian infants, gained 0.5 LAZ in the first 2 mo then remained at stable LAZ until 10 mo after which they rapidly declined to mean LAZ < −2.0 by 18 mo. Ponderal (WLZ) growth patterns were also qualitatively different between studies. The observed differences in post-natal growth are likely to be associated with differences in short and long term nutrition-related outcomes. The basis for these differences is unknown but likely to stem from both differences in infant feeding and drugs used for HIV prophylaxis. Grant Funding Source: Cornell Einaudi Center, WCMC Center for Global Health