Browsing by Subject "HIV exposure"

Now showing 1 - 3 of 3
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    Neurodevelopmental Outcomes of Young Children Born to HIV-Infected Mothers: A Pilot Study
    (Frontiers Media, 2021-10-21) McHenry, Megan S.; Oyungu, Eren; Yang, Ziyi; Ombitsa, Ananda R.; Cherop, Cleophas; Vreeman, Rachel C.; Pediatrics, School of Medicine
    Introduction: Over 15 million children who were exposed to HIV perinatally but uninfected (HEU) are alive globally, and they are faced with multiple risk factors for poor neurodevelopment. While children who are HIV-infected (HIV+) appear to have worse neurodevelopmental scores compared to children unexposed and uninfected with HIV (HUU), the evidence is mixed in children who are HEU. This small descriptive pilot study aimed to compare neurodevelopmental scores of children who are HIV+, HEU, and HUU in Kenya. Methods: This cross-sectional pilot study included children ages 18–36 months who were HIV+, HEU, or HUU. Neurodevelopment was assessed, along with sociodemographic, lab, and growth data. Statistical analysis included descriptive statistics, one-way ANOVA, chi-squared, and adjusted linear regression models. Results: One hundred seventy two were included (n = 24 HIV+; n = 74 HEU; n = 74 HUU). Mothers of children who were HEU experienced more depressive symptoms (p < 0.001). The only neurodevelopmental differences were found among groups was that children who were HIV+ had higher receptive language scores (p = 0.007). Lower height-for-age z-scores and being left home alone were associated with worse neurodevelopmental scores. Conclusions: Being stunted, left completely alone for at least an hour within the last week, and having higher sociodemographic status were associated with worse neurodevelopmental scores. The higher levels of depressive symptoms within mothers of children who are HEU warrants further investigation.
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    P-152. Chitinase-3-like Protein 1 is Associated with Stunting and Neurodevelopmental Delay in Ugandan Children Who Are HIV Exposed But Uninfected
    (Oxford University Press, 2025-01-29) MacBain, Elspeth; Conroy, Andrea; Namasopo, Sophie; Opoka, Robert; Hawkes, Michael; Pediatrics, School of Medicine
    Background: Children who are HIV exposed but uninfected (cHEU) are at risk for impaired linear growth and neurodevelopment, which evolving evidence suggests may be associated with elevated inflammatory biomarkers. Chitinase-3-like protein 1 (CHI3L1) is produced by activated neutrophils and has been linked to clinical manifestations of systemic inflammation in children living with HIV. We aimed to explore CHI3L1 as a potentially relevant marker for adverse growth and neurodevelopment outcomes experienced by cHEU. Methods: This was a prospective cohort study conducted at two pediatric HIV centres in Uganda (Jinja Regional Referral Hospital and Kambuga District Hospital). We enrolled children at birth, born to mothers living with HIV, diagnosed prior to the pregnancy or at the time of delivery. We excluded children who were subsequently found to be vertically infected (n=8), children who died before 18 month of age (n=3), as well as those lost-to-follow-up and those with missing CHI3L1 measurement. Neurodevelopmental ability (rank) was assigned based on the standardized score of Malawi Developmental Assessment Tool (MDAT) milestones achieved at 18 months of age. CHI3L1 levels were quantified by ELISA (R&D Duoset, Minneapolis, MN, USA). Results: We included 153 cHEU (53% female) born between March 2016 and June 2018. At 18 months of age, 42%, 0.7%, and 2.8%, were severely stunted, wasted, and underweight, respectively. Performance on the MDAT was similar to Malawian norms. The median CHI3L1 level was 30 µg/L (IQR 18-47). CHI3L1 levels were inversely correlated with weight-for-age (ρ= -0.22, p=0.0091) and height-for-age (ρ= -0.24, p=0.0039) z-scores, but not the weight-for-height or head circumference-for-age z-scores. CHI3L1 levels were higher in children with severe stunting (median 40 µg/L, IQR 26-86) than those without severe stunting (median 27 µg/L, IQR 16-39, p=0.0010). CHI3L1 was inversely correlated with the standardized MDAT scores (ρ= -0.29, 0.00023). Lower scores in the language and gross motor domains were associated with higher CHI3L1 whereas scores in the fine motor and social domains were not associated with CHI3L1. Conclusion: CHI3L1 was associated with severe stunting and neurodevelopmental delay in our cHEU cohort in Uganda.
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    The impact of HIV and ART exposure during pregnancy on fetal growth: a prospective study in a South African cohort
    (BMC, 2023-06-03) Mtintsilana, Asanda; Norris, Shane A.; Dlamini, Siphiwe N.; Nyati, Lukhanyo H.; Aronoff, David M.; Koethe, John R.; Goldstein, Jeffrey A.; Prioreschi, Alessandra; Medicine, School of Medicine
    Background: In utero exposure to human immunodeficiency virus (HIV) and antiretroviral (ART) is associated with adverse birth outcomes, which are often attributed to alterations in placental morphology. This study used structural equation models (SEMs) to examine the impact of HIV and ART exposure on fetal growth outcomes and whether these associations are mediated by placental morphology in urban-dwelling Black South African women. Methods: This prospective cohort study included pregnant women living with HIV (WLWH, n = 122) and not living with HIV (WNLWH, n = 250) that underwent repeated ultrasonography during pregnancy, and at delivery, to determine fetal growth parameters in Soweto, South Africa. The size and the velocity of fetal growth measures (i.e., head and abdominal circumference, biparietal diameter, and femur length) were calculated using the Superimposition by Translation and Rotation. Placenta digital photographs taken at delivery were used to estimate morphometric parameters and trimmed placental weight was measured. All WLWH were receiving ART for the prevention of vertical transmission of HIV. Results: A trend towards a lower placental weight and significantly shorter umbilical cord length was reported in WLWH compared to their counterparts. After sex stratification, umbilical cord length was significantly shorter in males born to WLWH than in male fetuses born to WNLWH (27.3 (21.6-32.8) vs. 31.4 (25.0-37.0) cm, p = 0.015). In contrast, female fetuses born to WLWH had lower placental weight, birth weight (2.9 (2.3-3.1) vs. 3.0 (2.7-3.2) kg), and head circumference (33 (32-34) vs. 34 (33-35) cm) than their counterparts (all p ≤ 0.05). The SEM models showed an inverse association between HIV and head circumference size and velocity in female fetuses. In contrast, HIV and ART exposure was positively associated with femur length growth (both size and velocity) and abdominal circumference velocity in male fetuses. None of these associations appeared to be mediated via placental morphology. Conclusion: Our findings suggest that HIV and ART exposure directly affects head circumference growth in females and abdominal circumference velocity in male fetuses; but may improve femur length growth in male fetuses only.