Growth at Two Years of Age in HIV-Exposed Uninfected Children in the US by Trimester of Maternal Antiretroviral Initiation

For the Pediatric HIVAIDS Cohort Study

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND:: Abnormal childhood growth may affect future health. Maternal tenofovir (TFV) use was associated with lower body length and head circumference at one year of age in HIV-exposed uninfected (HEU) US children. METHODS:: We studied 509 HEU children in the US-based Surveillance Monitoring of ART 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 CDC 2000 growth z-scores at 2 years of age within trimester of cART initiation: weight (WTZ), length (LNZ), weight-for-length (WFLZ), triceps skinfold z-score (TSFZ), and head circumference (HCZ). RESULTS:: Mothers mean age was 28.6 years; 57% were black non-Hispanic and 19% delivered at <37 weeks gestation. At 2 years, mean WTZ, LNZ, WFLZ, and HCZ, were above average (P<0.05), while TSFZ (P=0.57) did not differ from average. WFLZ was >1.64 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%CI -0.10, 1.00) and lower TSFZ (-0.55 SD, 95%CI -1.07, -0.02) compared to zidovudine+lamivudine-exposed. 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 two years of age, as hypothesized, but may be related to greater weight among those exposed to cART early in pregnancy.

Original languageEnglish (US)
JournalPediatric Infectious Disease Journal
DOIs
StateAccepted/In press - Oct 27 2016

Fingerprint

Tenofovir
Mothers
HIV
Growth
Head
Weights and Measures
Therapeutics
Pregnancy
Lamivudine
Zidovudine
Second Pregnancy Trimester
First Pregnancy Trimester
Centers for Disease Control and Prevention (U.S.)
Protease Inhibitors
Health

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Growth at Two Years of Age in HIV-Exposed Uninfected Children in the US by Trimester of Maternal Antiretroviral Initiation. / For the Pediatric HIVAIDS Cohort Study.

In: Pediatric Infectious Disease Journal, 27.10.2016.

Research output: Contribution to journalArticle

@article{1b35d02e0061463a9edc67a524ae0513,
title = "Growth at Two Years of Age in HIV-Exposed Uninfected Children in the US by Trimester of Maternal Antiretroviral Initiation",
abstract = "BACKGROUND:: Abnormal childhood growth may affect future health. Maternal tenofovir (TFV) use was associated with lower body length and head circumference at one year of age in HIV-exposed uninfected (HEU) US children. METHODS:: We studied 509 HEU children in the US-based Surveillance Monitoring of ART 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 CDC 2000 growth z-scores at 2 years of age within trimester of cART initiation: weight (WTZ), length (LNZ), weight-for-length (WFLZ), triceps skinfold z-score (TSFZ), and head circumference (HCZ). RESULTS:: Mothers mean age was 28.6 years; 57{\%} were black non-Hispanic and 19{\%} delivered at <37 weeks gestation. At 2 years, mean WTZ, LNZ, WFLZ, and HCZ, were above average (P<0.05), while TSFZ (P=0.57) did not differ from average. WFLZ was >1.64 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{\%}CI -0.10, 1.00) and lower TSFZ (-0.55 SD, 95{\%}CI -1.07, -0.02) compared to zidovudine+lamivudine-exposed. 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 two years of age, as hypothesized, but may be related to greater weight among those exposed to cART early in pregnancy.",
author = "{For the Pediatric HIVAIDS Cohort Study} and Jacobson, {Denise L.} and Kunjal Patel and Williams, {Paige L.} and Geffner, {Mitchell E.} and Siberry, {George K.} and Dimeglio, {Linda A.} and Crain, {Marilyn J.} and Ayesha Mirza and Chen, {Janet S.} and Elizabeth McFarland and Deborah Kacanek and Margarita Silio and Kenneth Rich and William Borkowsky and {van Dyke}, {Russell B.} and Scott, {Gwendolyn B}",
year = "2016",
month = "10",
day = "27",
doi = "10.1097/INF.0000000000001387",
language = "English (US)",
journal = "Pediatric Infectious Disease Journal",
issn = "0891-3668",
publisher = "Lippincott Williams and Wilkins",

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T1 - Growth at Two Years of Age in HIV-Exposed Uninfected Children in the US by Trimester of Maternal Antiretroviral Initiation

AU - For the Pediatric HIVAIDS Cohort Study

AU - Jacobson, Denise L.

AU - Patel, Kunjal

AU - Williams, Paige L.

AU - Geffner, Mitchell E.

AU - Siberry, George K.

AU - Dimeglio, Linda A.

AU - Crain, Marilyn J.

AU - Mirza, Ayesha

AU - Chen, Janet S.

AU - McFarland, Elizabeth

AU - Kacanek, Deborah

AU - Silio, Margarita

AU - Rich, Kenneth

AU - Borkowsky, William

AU - van Dyke, Russell B.

AU - Scott, Gwendolyn B

PY - 2016/10/27

Y1 - 2016/10/27

N2 - BACKGROUND:: Abnormal childhood growth may affect future health. Maternal tenofovir (TFV) use was associated with lower body length and head circumference at one year of age in HIV-exposed uninfected (HEU) US children. METHODS:: We studied 509 HEU children in the US-based Surveillance Monitoring of ART 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 CDC 2000 growth z-scores at 2 years of age within trimester of cART initiation: weight (WTZ), length (LNZ), weight-for-length (WFLZ), triceps skinfold z-score (TSFZ), and head circumference (HCZ). RESULTS:: Mothers mean age was 28.6 years; 57% were black non-Hispanic and 19% delivered at <37 weeks gestation. At 2 years, mean WTZ, LNZ, WFLZ, and HCZ, were above average (P<0.05), while TSFZ (P=0.57) did not differ from average. WFLZ was >1.64 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%CI -0.10, 1.00) and lower TSFZ (-0.55 SD, 95%CI -1.07, -0.02) compared to zidovudine+lamivudine-exposed. 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 two years of age, as hypothesized, but may be related to greater weight among those exposed to cART early in pregnancy.

AB - BACKGROUND:: Abnormal childhood growth may affect future health. Maternal tenofovir (TFV) use was associated with lower body length and head circumference at one year of age in HIV-exposed uninfected (HEU) US children. METHODS:: We studied 509 HEU children in the US-based Surveillance Monitoring of ART 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 CDC 2000 growth z-scores at 2 years of age within trimester of cART initiation: weight (WTZ), length (LNZ), weight-for-length (WFLZ), triceps skinfold z-score (TSFZ), and head circumference (HCZ). RESULTS:: Mothers mean age was 28.6 years; 57% were black non-Hispanic and 19% delivered at <37 weeks gestation. At 2 years, mean WTZ, LNZ, WFLZ, and HCZ, were above average (P<0.05), while TSFZ (P=0.57) did not differ from average. WFLZ was >1.64 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%CI -0.10, 1.00) and lower TSFZ (-0.55 SD, 95%CI -1.07, -0.02) compared to zidovudine+lamivudine-exposed. 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 two years of age, as hypothesized, but may be related to greater weight among those exposed to cART early in pregnancy.

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