Peer-reviewed article
Body composition of children born HIV-exposed uninfected in rural Zimbabwe
Joseph D. Piper, Robert Ntozini, Idah Mapurisa, Tsitsi Mashedze, Clever Mazhanga et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This study compared body composition in 2-year-old children in rural Zimbabwe who were born to mothers with HIV but were not infected themselves (HIV-exposed uninfected, CHEU) to children whose mothers did not have HIV (CHU). CHEU children were smaller and had less lean muscle mass and less body fat than CHU children. These differences were not explained by shorter length or lower birthweight. The findings suggest CHEU children have a distinct growth pattern that may help explain why they face higher risks of illness, death and developmental problems.
Key points
- CHEU had significantly lower length-for-age, knee-heel length, weight-for-age, mid-upper arm circumference and calf circumference than CHU.
- CHEU had a lower impedance index (adjusted mean difference -0.49), indicating less lean mass.
- CHEU had lower subscapular (-0.49) and triceps (-0.48) skinfold Z-scores, indicating reduced subcutaneous fat.
- CHEU had lower birthweight in early life.
- No significant interaction was found between stunting or birthweight and HIV exposure for body composition outcomes.
Limitations
The study was a substudy with a relatively small number of HIV-exposed children (36) compared to unexposed (187), and it cannot establish why these body composition differences occur or confirm long-term health consequences.
Abstract
BACKGROUND: Globally, 15 million children were born HIV-exposed uninfected (CHEU) from mothers living with HIV. CHEU have increased mortality, morbidity and stunting compared to children HIV-unexposed (CHU). Our objective was to compare body composition between CHEU and CHU, which may underlie this vulnerability. METHODS: In a substudy among 223 children (36 CHEU and 187 CHU) enrolled in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe, we measured height, knee-heel length, weight, calf circumference, skinfold thicknesses (triceps, subscapular and calf), and bio-electrical impedance at 2 years of age. Generalised estimating equations were used to compare body composition between CHEU and CHU, and interactions with linear growth and birthweight. RESULTS: CHEU had significantly lower length-for-age, knee-heel length, weight-for-age, mid-upper arm circumference and calf circumference compared to CHU. CHEU had a lower impedance index (adjusted mean difference -0.49, 95% CI -0.87, -0.11), reflecting less lean mass, and lower skinfold thicknesses (subscapular Z-score adjusted mean difference -0.49 (95% CI -0.97, -0.02); triceps Z-score -0.48 (95% CI -0.83, -0.13)), indicating reduced subcutaneous fat. In early-life, CHEU had lower birthweight. However, no significant interaction between stunting or birthweight and HIV exposure was observed for body composition outcomes. CONCLUSION: CHEU have a distinct pattern of body composition by 2 years of age, characterised by reduced lean and fat mass compared to CHU which was not explained by reduced linear growth or lower birthweight. This pattern of early-life growth may contribute to the increased vulnerability of CHEU to mortality, morbidity and reduced neurodevelopment.