Growth of HIV-Exposed Uninfected Infants in the First 6 Months of Life in South Africa: The IeDEA-SA Collaboration
Identifieur interne : 001019 ( Main/Exploration ); précédent : 001018; suivant : 001020Growth of HIV-Exposed Uninfected Infants in the First 6 Months of Life in South Africa: The IeDEA-SA Collaboration
Auteurs : Erna Morden [Afrique du Sud] ; Karl-Günter Technau [Afrique du Sud] ; Janet Giddy [Afrique du Sud] ; Nicola Maxwell [Afrique du Sud] ; Olivia Keiser [Suisse] ; Mary-Ann Davies [Afrique du Sud]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
HIV-exposed uninfected (HEU) infants are a growing population in sub-Saharan Africa especially with the increasing coverage of more effective prevention of mother-to-child transmission (PMTCT) antiretroviral therapy regimens. This study describes the characteristics of South African HEU infants, investigates factors impacting birth weight and assesses their growth within the first 28 weeks of life.
This is a retrospective cohort based on routine clinical data from two South African PMTCT programmes. Data were collected between 2007 and 2013. Linear regression assessed factors affecting birth weight-for-age z-scores (WAZ) while growth (longitudinal WAZ) was assessed using mixed effects models.
We assessed the growth of 2621 HEU infants (median birth WAZ was -0.65 (IQR -1.46; 0.0) and 51% were male). The feeding modalities practised were as follows: 0.5% exclusive breastfeeding, 7.9% breastfeeding with unknown exclusivity, 0.08% mixed breastfeeding and 89.2% formula feeding. Mothers with CD4 <200 cells/μl delivered infants with a lower birth WAZ (adjusted ß -0.253 [95% CI -0.043; -0.072], p = 0.006) compared to mothers with aCD4 ≥500 cells/μl. Similarly, mothers who did not receive antiretroviral drugs delivered infants with a lower birth WAZ (adjusted ß -0.39 [95% CI -0.67; -0.11], p = 0.007) compared to mothers who received antenatal antiretrovirals. Infants with a birth weight <2 500g (ß 0.070 [95% CI 0.061; 0.078], p <0.0001) experienced faster growth within the first 28 weeks of life compared to infants with a birth weight ≥2 500g. Infants with any breastfeeding exposure experienced slower longitudinal growth compared to formula fed infants (adjusted ß -0.012 [95% CI 0.021; -0.003], p = 0.011).
Less severe maternal disease and the use of antiretrovirals positively impacts birth weight in this cohort of South African HEU infants. Formula feeding was common with breastfed infants experiencing marginally slower longitudinal growth.
Url:
DOI: 10.1371/journal.pone.0151762
PubMed: 27049853
PubMed Central: 4822941
Affiliations:
- Afrique du Sud, Suisse
- Canton de Berne, Gauteng
- Berne, Johannesbourg
- Université de Berne, Université du Witwatersrand
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Morden</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health and Family Medicine, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Technau, Karl Gunter" sort="Technau, Karl Gunter" uniqKey="Technau K" first="Karl-Günter" last="Technau">Karl-Günter Technau</name><affiliation wicri:level="4"><nlm:aff id="aff002"><addr-line>Rahima Moosa Mother and Child Hospital and University of the Witwatersrand, Johannesburg, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Rahima Moosa Mother and Child Hospital and University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Giddy, Janet" sort="Giddy, Janet" uniqKey="Giddy J" first="Janet" last="Giddy">Janet Giddy</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>McCord Hospital, Durban, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>McCord Hospital, Durban</wicri:regionArea><wicri:noRegion>Durban</wicri:noRegion></affiliation></author><author><name sortKey="Maxwell, Nicola" sort="Maxwell, Nicola" uniqKey="Maxwell N" first="Nicola" last="Maxwell">Nicola Maxwell</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health and Family Medicine, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Keiser, Olivia" sort="Keiser, Olivia" uniqKey="Keiser O" first="Olivia" last="Keiser">Olivia Keiser</name><affiliation wicri:level="4"><nlm:aff id="aff004"><addr-line>Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region><settlement type="city">Berne</settlement></placeName><orgName type="university">Université de Berne</orgName></affiliation></author><author><name sortKey="Davies, Mary Ann" sort="Davies, Mary Ann" uniqKey="Davies M" first="Mary-Ann" last="Davies">Mary-Ann Davies</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health and Family Medicine, University of Cape Town, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>HIV-exposed uninfected (HEU) infants are a growing population in sub-Saharan Africa especially with the increasing coverage of more effective prevention of mother-to-child transmission (PMTCT) antiretroviral therapy regimens. This study describes the characteristics of South African HEU infants, investigates factors impacting birth weight and assesses their growth within the first 28 weeks of life.</p></sec><sec id="sec002"><title>Methods</title><p>This is a retrospective cohort based on routine clinical data from two South African PMTCT programmes. Data were collected between 2007 and 2013. Linear regression assessed factors affecting birth weight-for-age z-scores (WAZ) while growth (longitudinal WAZ) was assessed using mixed effects models.</p></sec><sec id="sec003"><title>Results</title><p>We assessed the growth of 2621 HEU infants (median birth WAZ was -0.65 (IQR -1.46; 0.0) and 51% were male). The feeding modalities practised were as follows: 0.5% exclusive breastfeeding, 7.9% breastfeeding with unknown exclusivity, 0.08% mixed breastfeeding and 89.2% formula feeding. Mothers with CD4 <200 cells/μl delivered infants with a lower birth WAZ (adjusted ß -0.253 [95% CI -0.043; -0.072], p = 0.006) compared to mothers with aCD4 ≥500 cells/μl. Similarly, mothers who did not receive antiretroviral drugs delivered infants with a lower birth WAZ (adjusted ß -0.39 [95% CI -0.67; -0.11], p = 0.007) compared to mothers who received antenatal antiretrovirals. Infants with a birth weight <2 500g (ß 0.070 [95% CI 0.061; 0.078], p <0.0001) experienced faster growth within the first 28 weeks of life compared to infants with a birth weight ≥2 500g. Infants with any breastfeeding exposure experienced slower longitudinal growth compared to formula fed infants (adjusted ß -0.012 [95% CI 0.021; -0.003], p = 0.011).</p></sec><sec id="sec004"><title>Conclusion</title><p>Less severe maternal disease and the use of antiretrovirals positively impacts birth weight in this cohort of South African HEU infants. 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Heidari</name></author><author><name sortKey="Mofenson, L" uniqKey="Mofenson L">L Mofenson</name></author><author><name sortKey="Cotton, Mf" uniqKey="Cotton M">MF Cotton</name></author><author><name sortKey="Marlink, R" uniqKey="Marlink R">R Marlink</name></author><author><name sortKey="Cahn, P" uniqKey="Cahn P">P Cahn</name></author><author><name sortKey="Katabira, E" uniqKey="Katabira E">E Katabira</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Ramokolo, V" uniqKey="Ramokolo V">V Ramokolo</name></author><author><name sortKey="Lombard, C" uniqKey="Lombard C">C Lombard</name></author><author><name sortKey="Fadnes, Lt" uniqKey="Fadnes L">LT Fadnes</name></author><author><name sortKey="Doherty, T" uniqKey="Doherty T">T Doherty</name></author><author><name sortKey="Jackson, Dj" uniqKey="Jackson D">DJ Jackson</name></author><author><name sortKey="Goga, Ae" uniqKey="Goga A">AE Goga</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kuhn, L" uniqKey="Kuhn L">L Kuhn</name></author><author><name sortKey="Aldrovandi, Gm" uniqKey="Aldrovandi G">GM Aldrovandi</name></author><author><name sortKey="Sinkala, M" uniqKey="Sinkala M">M Sinkala</name></author><author><name sortKey="Kankasa, C" uniqKey="Kankasa C">C Kankasa</name></author><author><name sortKey="Semrau, K" uniqKey="Semrau K">K Semrau</name></author><author><name sortKey="Kasonde, P" uniqKey="Kasonde P">P Kasonde</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kuhn, L" uniqKey="Kuhn L">L Kuhn</name></author><author><name sortKey="Sinkala, M" uniqKey="Sinkala M">M Sinkala</name></author><author><name sortKey="Kankasa, C" uniqKey="Kankasa C">C Kankasa</name></author><author><name sortKey="Semrau, K" uniqKey="Semrau K">K Semrau</name></author><author><name sortKey="Kasonde, P" uniqKey="Kasonde P">P Kasonde</name></author><author><name sortKey="Scott, N" uniqKey="Scott N">N Scott</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Iliff, P" uniqKey="Iliff P">P Iliff</name></author><author><name sortKey="Piwoz, E" uniqKey="Piwoz E">E Piwoz</name></author><author><name sortKey="Tavengwa, N" uniqKey="Tavengwa N">N Tavengwa</name></author><author><name sortKey="Zunguza, C" uniqKey="Zunguza C">C Zunguza</name></author><author><name sortKey="Marinda, E" uniqKey="Marinda E">E Marinda</name></author><author><name sortKey="Nathoo, K" uniqKey="Nathoo K">K Nathoo</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Suisse</li></country><region><li>Canton de Berne</li><li>Gauteng</li></region><settlement><li>Berne</li><li>Johannesbourg</li></settlement><orgName><li>Université de Berne</li><li>Université du Witwatersrand</li></orgName></list><tree><country name="Afrique du Sud"><noRegion><name sortKey="Morden, Erna" sort="Morden, Erna" uniqKey="Morden E" first="Erna" last="Morden">Erna Morden</name></noRegion><name sortKey="Davies, Mary Ann" sort="Davies, Mary Ann" uniqKey="Davies M" first="Mary-Ann" last="Davies">Mary-Ann Davies</name><name sortKey="Giddy, Janet" sort="Giddy, Janet" uniqKey="Giddy J" first="Janet" last="Giddy">Janet Giddy</name><name sortKey="Maxwell, Nicola" sort="Maxwell, Nicola" uniqKey="Maxwell N" first="Nicola" last="Maxwell">Nicola Maxwell</name><name sortKey="Technau, Karl Gunter" sort="Technau, Karl Gunter" uniqKey="Technau K" first="Karl-Günter" last="Technau">Karl-Günter Technau</name></country><country name="Suisse"><region name="Canton de Berne"><name sortKey="Keiser, Olivia" sort="Keiser, Olivia" uniqKey="Keiser O" first="Olivia" last="Keiser">Olivia Keiser</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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