Growth and Development Status in the First Two Years of Uninfected Children Born From HIV Positive Mothers
Recently prevention of HIV transmission from mother to child by antiretroviral regimens has resulted in growing the numbers of HIV exposed but uninfected children (HIV-EU). The aim of present study was evaluation of growth and neurodevelopment status among less than 2-year-old HIV exposed uninfected children. A cohort study was carried out at Vali-e-Asr Hospital (Tehran-Iran). Thirty-nine HIV-EU neonates were recruited (2014 to 2016). Neonates and infants with concern to growth and neurodevelopment status were evaluated at 6, 12, 18, and 24 months by an expert physician. Neurodevelopment assessment was based on WHO Milestones Chart and Age and Stage Questionnaire. Of all children, 22 were male, and 17 were female. Regarding growth indices, although mean birth weight in half of the neonates was lower than normal population; no postnatal descending trend was observed in their growth chart. No significant differences were found between two groups' height and head circumference. Among the neurodevelopmental parameters measured, in 6th months of life, 2 cases had abnormality in the gross motor while at 12 months, 6 cases had delay in language, social problem, and motor disorders. At 18 and 24 months, 7 infants showed developmental problems of which 71.4% of their mothers were younger than others (age<25 years, P=0.009). Prevalence of neurodevelopmental disorders including delay in language, motor, and social domains was common among HIV-EU children. As several environmental factors may involve the etiology of neurodevelopmental disorders, nearly-full postnatal control and prevention seem necessary.
Okoko N, Owuor KO, Kulzer JL , Owino GP, Ogolla IA,Wandera R, et al. Factors associated with mother to childtransmission of HIV despite overall low transmissionrates in HIV-exposed infants in rural Kenya. Int J STDAIDS 2017;28:1215-23.
Kuona P, Kandawasvika G, Gumbo F, Nathoo K,Pedersen B. Growth and Development of the HIVExposed Uninfected Children below 5 Years inDeveloping Countries: Focus on Nutritional Challenges,Mortality and Neurocognitive Function. Food Nutr Sci
Briand N, Mandelbrot L, Le Chenadec J, Tubiana R,Teglas JP, Faye A, et al. No relationship between in-uteroexposure toHAART and intrauterine growth retardation.AIDS 2009;23:1235-43.
Townsend CL, Cortina-Borja M, Peckham CS, TookeyPA. Antiretroviral therapy and premature deliveryindiagnosed HIV-infected women in the United Kingdomand Ireland. AIDS 2007;21:1019-26.
Ekouevi DK, Coffie PA, Becquet R, Tonwe-Gold B,Horo A, Thiebaut R, et al. Antiretroviral therapy inpregnant women with advanced HIV disease andpregnancy outcomes in Abidjan, Cote d’Ivoire. AIDS2008;22:1815-20.
Kelly MS, Wirth KE, Steenhoff AP, Cunningham CK,Mills TA, Boiditswe SC, et al. Treatment Failures andExcess Mortality Among HIV-Exposed, UninfectedChildren With Pneumonia. J Pediatric Infect Dis Soc2015;4:117-26.
Thorne C, Newell ML. Safety of agents used to preventmothertochild transmission of HIV: is there any causefor concern? Drug Saf 2007;30:203-13.
European Collaborative Study. Exposure to antiretroviral therapy in utero or early life: the health of uninfectedchildren born to HIVinfected women. J Acquir ImmuneDefic Syndr 2003;32:380-7.
Chase C, Ware J, Hittelman J, Blasini I, Blasini I, Smith R, Llorente A, et al. Early cognitive and motordevelopment among infants born to women infected with human immunodeficiency virus. Women and InfantsTransmission Study Group. Pediatrics 2000;106:E25.
Williams PL, Marino M, Malee K, Brogly S, Hughes MD, Mofenson LM, et al. Neurodevelopment and InUtero Antiretroviral Exposure of HIV-ExposedUninfected Infants. Pediatrics 2010;125:e250-60.
Christofides NJ, Jewkes RK, Dunkle KL, Nduna M, JamaN, Sterk C. Early adolescent pregnancy increases risk ofincident HIV infection in the Eastern Cape, South Africa:a longitudinal study. J Int AIDS Soc 2014;17:18585.
Filteau S. The HIV-exposed, uninfected African child.Trop Med Int Health 2009;14:276-87.
Businge CB, Longo-Mbenza B. Mathews V. Risk factorsfor incident HIV infection among antenatal mothers in rural Eastern Cape, South Africa. Glob Health Action2016;9:29060.
Sugandhi N, Rodrigues J, Kim M, Ahmed S, Amzel A,Tolle M, et al. HIV Exposed Infants: Rethinking care fora lifelong condition. AIDS 2013;27:S187-95.
Powis KM, Smeaton L, Ogwu A, Lockman S, Dryden-Peterson S, van Widenfelt E, et al. Effects of in uteroantiretroviral exposure on longitudinal growth of HIVexposed uninfected infants in Botswana. J AcquirImmune Defic Syndr 2011;56:131-8.
Agostoni C, Zuccotti G, Giovannini M, Decarlis S,Giannì ML, Piacentini E, et al. Growth in the first twoyears of uninfected children born to HIV-1 seropositivemothers. Arch Dis Child 1998;79:175-8.
Morden E, Technau K, Giddy G, Maxwell N, Keiser O,Davies M. Growth of HIV-Exposed Uninfected Infants inthe First 6 Months of Life in South Africa: The IeDEASACollaboration. PLoS One 2016;11:e0151762.
Puthanakit T, Ananworanich J, Vonthanak S, KosalaraksaP, Hansudewechakul R, van der Lugt J, et al. Cognitive function and neurodevelopmental outcomes in HIVinfectedchildrenolder than 1 year of age randomized to early versus deferred anti-retroviral therapy: ThePREDICTneurodevelopmental study. J Pediatric InfectDis Soc 2013;32:501-8.
Malee KM, Mellins CA, Huo Y, Tassiopoulos K, SmithR, Sirois PA. Prevalence, incidence, and persistence ofpsychiatric and substance use disorders among mothersliving with HIV. J Acquir Immune Defic Syndr2014;65:526-34.
Kartik KV, Mark NL, Elizabeth WT, Guy DB, Harwell J. Growth of infants born to HIV-infected women in SouthAfricaaccording to maternal and infant characteristic.Trop Med Int Health 2010;15:1364-74.
Kerr SJ, Puthanakita TK, Ung V, Aurpibule L,Vonthanakf S, Kosalaraksag P, Neurodevelopmentaloutcomes in HIVexposeduninfected children versusthose not exposed to HIV. AIDS Care 2014;26:1327-35.
Williams PL, Hazra R, Van Dyke RB, Yildirim C, CrainMJ, Seage GR 3rd, et al. Antiretroviral exposure duringpregnancy and adverse outcomes in HIV-exposeduninfected infants and children using a trigger-baseddesign. AIDS 2016;30:133-44.
Knight W, Mellins CA, Levenson RL Jr, Arpadi SM,Kairam R. Effects of Pediatric HIV Infection on Mentaland Psychomotor Development. J Pediatr Psychol2000;25:583-7.
Van Rie A, Mupuala A, Dow A. Impact of the HIV⁄AIDSepidemic on the neurodevelopment of preschool-agedchildren in Kinshasa, Democratic Republic of Congo.Pediatrics 2008;122:e123-8.
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