BACKGROUND: The risk of HIV-1 infection is high among breast-fed children in sub-Saharan Africa. Monitoring the nutritional status can provide useful information to determine the effect of HIV infection and breast-feeding on child growth and development. We longitudinally assessed the nutritional status and determined its association with HIV infection and breast-feeding among Malawian children. METHODS: We analyzed data from 2 clinical trials to prevent mother-to-child transmission of HIV in Malawi. These trials were conducted during 2000-2003 before the current guidelines were implemented to breast-feed exclusively during the first 6 months and wean thereafter. The nutritional status of children was measured up to age 24 months, using z-scores. Age-specific differences in length-for-age (L/A), weight-for-age (W/A), and weight-for-length (W/L) were compared stratifying by gender and HIV infection status. Multivariable models examined the mean change in z-scores controlling for breast-feeding and other factors. RESULTS: In this analysis, 1589 children were included. Boys had significantly lower L/A scores and became stunted (z-score -<2 standard deviations) earlier than girls. HIV-infected children had significantly lower mean L/A and W/A z-scores than HIV-uninfected children and became stunted and underweight at an earlier age. In multivariable analysis not being breast-fed and being HIV infected were significantly (P < 0.001) associated with decreases in mean L/A, W/A, and W/L z-scores. CONCLUSIONS: This study shows the impact of infant HIV infection on growth and supports the critical importance of breast-feeding. Mother-to-child transmission of HIV programs should endeavor to preserve breast-feeding and find alternative measures to prevent postnatal HIV transmission.
BACKGROUND: The risk of HIV-1 infection is high among breast-fed children in sub-Saharan Africa. Monitoring the nutritional status can provide useful information to determine the effect of HIV infection and breast-feeding on child growth and development. We longitudinally assessed the nutritional status and determined its association with HIV infection and breast-feeding among Malawian children. METHODS: We analyzed data from 2 clinical trials to prevent mother-to-child transmission of HIV in Malawi. These trials were conducted during 2000-2003 before the current guidelines were implemented to breast-feed exclusively during the first 6 months and wean thereafter. The nutritional status of children was measured up to age 24 months, using z-scores. Age-specific differences in length-for-age (L/A), weight-for-age (W/A), and weight-for-length (W/L) were compared stratifying by gender and HIV infection status. Multivariable models examined the mean change in z-scores controlling for breast-feeding and other factors. RESULTS: In this analysis, 1589 children were included. Boys had significantly lower L/A scores and became stunted (z-score -<2 standard deviations) earlier than girls. HIV-infectedchildren had significantly lower mean L/A and W/A z-scores than HIV-uninfected children and became stunted and underweight at an earlier age. In multivariable analysis not being breast-fed and being HIV infected were significantly (P < 0.001) associated with decreases in mean L/A, W/A, and W/L z-scores. CONCLUSIONS: This study shows the impact of infantHIV infection on growth and supports the critical importance of breast-feeding. Mother-to-child transmission of HIV programs should endeavor to preserve breast-feeding and find alternative measures to prevent postnatal HIV transmission.
Authors: Taha E Taha; Donald R Hoover; Shu Chen; Newton I Kumwenda; Linda Mipando; Kondwani Nkanaunena; Michael C Thigpen; Allan Taylor; Mary Glenn Fowler; Lynne M Mofenson Journal: Clin Infect Dis Date: 2011-08 Impact factor: 9.079
Authors: Taha E Taha; Sufia S Dadabhai; Jin Sun; M Hafizur Rahman; Johnstone Kumwenda; Newton Kumwenda Journal: J Acquir Immune Defic Syndr Date: 2012-10-01 Impact factor: 3.731
Authors: Charlotte E Lane; Emily A Bobrow; Diuedonne Ndatimana; Gilles F Ndayisaba; Linda S Adair Journal: Matern Child Nutr Date: 2019-01-29 Impact factor: 3.092
Authors: Valerie L Flax; Margaret E Bentley; Charles S Chasela; Dumbani Kayira; Michael G Hudgens; Kopekani Z Kacheche; Charity Chavula; Athena P Kourtis; Denise J Jamieson; Charles M van der Horst; Linda S Adair Journal: J Nutr Date: 2013-03-06 Impact factor: 4.798
Authors: Goodarz Danaei; Kathryn G Andrews; Christopher R Sudfeld; Günther Fink; Dana Charles McCoy; Evan Peet; Ayesha Sania; Mary C Smith Fawzi; Majid Ezzati; Wafaie W Fawzi Journal: PLoS Med Date: 2016-11-01 Impact factor: 11.069