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Growth at 2 Years of Age in HIV-exposed Uninfected Children in the United States by Trimester of Maternal Antiretroviral Initiation
Journal article   Open access   Peer reviewed

Growth at 2 Years of Age in HIV-exposed Uninfected Children in the United States by Trimester of Maternal Antiretroviral Initiation

Denise L. Jacobson, Kunjal Patel, Paige L. Williams, Mitchell E. Geffner, George K. Siberry, Linda A. DiMeglio, Marilyn J. Crain, Ayesha Mirza, Janet S. Chen, Elizabeth McFarland, …
The Pediatric infectious disease journal, v 36(2), pp 189-197
01 Feb 2017
DOI: https://doi.org/10.1097/INF.0000000000001387
PMID: 27798548
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc5526594View
Accepted (AM),  Open

Abstract

Immunology Infectious Diseases Life Sciences & Biomedicine Pediatrics Science & Technology
Background: Abnormal childhood growth may affect future health. Maternal tenofovir (TFV) use was associated with lower body length and head circumference at 1 year of age in HIV-exposed uninfected (HEU) US children. Methods: We studied 509 HEU children in the US-based Surveillance Monitoring of Antiretroviral Therapy Toxicities cohort whose HIV-infected mothers were not using antiretrovirals at the last menstrual period and began combination antiretroviral therapy (cART) in pregnancy (cART initiators). We examined adjusted associations between antiretrovirals and Centers for Disease Control 2000 growth Z scores at 2 years of age within trimester of cART initiation: weight (weight Z score), length (length Z score), weightfor- length [ weight-for-length Z score (WFLZ)], triceps skinfold Z score (TSFZ) and head circumference (head circumference Z score). Results: Mothers mean age was 28.6 years; 57% were black non-Hispanic and 19% delivered at < 37 weeks gestation. At 2 years, mean weight Z score, length Z score, WFLZ and head circumference Z score were above average (P < 0.05), whereas TSFZ (P = 0.57) did not differ from average. WFLZ was > 1.64 standard deviation (SD) (> 95th percentile) in 13%. Among children of first-trimester cART initiators, TFV+ emtricitabine-exposed children had slightly higher mean WFLZ (0.45 SD; 95% confidence interval: -0.10 to 1.00) and lower TSFZ (-0.55 SD; 95% confidence interval: -1.07 to -0.02) compared with zidovudine+ lamivudine-exposed children. TSFZ was lower in those exposed to boosted protease inhibitors. In contrast, growth in children of second trimester cART initiators did not differ by antiretroviral exposures. Conclusion: Growth was above average in HEU; 13% were obese. Maternal TFV use was not associated with lower length or head circumference at 2 years of age, as hypothesized, but may be related to greater weight among those exposed to cART early in pregnancy.

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19 citations in Web of Science
23 citations in Scopus

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Immunology
Infectious Diseases
Pediatrics
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