Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India
<p>Abstract</p> <p>Background</p> <p>India has among the highest rates of infant malnutrition. Few studies investigating the growth patterns of HIV-exposed infants in India or the impact of timing of HIV infection on growth in settings such as India exist.</p> <...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2012-10-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1471-2334/12/282 |
| _version_ | 1818643700401569792 |
|---|---|
| author | Ram Malathi Gupte Nikhil Nayak Uma Kinikar Aarti A Khandave Mangesh Shankar Anita V Sastry Jayagowri Bollinger Robert C Gupta Amita |
| author_facet | Ram Malathi Gupte Nikhil Nayak Uma Kinikar Aarti A Khandave Mangesh Shankar Anita V Sastry Jayagowri Bollinger Robert C Gupta Amita |
| author_sort | Ram Malathi |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>India has among the highest rates of infant malnutrition. Few studies investigating the growth patterns of HIV-exposed infants in India or the impact of timing of HIV infection on growth in settings such as India exist.</p> <p>Methods</p> <p>We used data from the Six Week Extended Nevirapine (SWEN) trial to compare the growth patterns of HIV-infected and HIV-exposed but uninfected infants accounting for timing of HIV infection, and to identify risk factors for stunting, underweight and wasting. Growth and timing of HIV infection were assessed at weeks 1, 2, 4, 6, 10, 14 weeks and 6, 9, 12 months of life. Random effects multivariable logistic regression method was used to assess factors associated with stunting, underweight and wasting.</p> <p>Results</p> <p>Among 737 HIV-exposed infants, 93 (13%) were HIV-infected by 12 months of age. Among HIV-infected and uninfected infants, baseline prevalence of stunting (48% vs. 46%), underweight (27% vs. 26%) and wasting (7% vs. 11%) was similar (p>0.29), but by 12 months stunting and underweight, but not wasting, were significantly higher in HIV-infected infants (80% vs. 56%, 52% vs. 29%, p< 0.0001; 5% vs. 6%, p=0.65, respectively). These differences rapidly manifested within 4–6 weeks of birth. Infants infected in utero had the worst growth outcomes during the follow-up period. SWEN was associated with non-significant reductions in stunting and underweight among HIV-infected infants and significantly less wasting in HIV-uninfected infants. In multivariate analysis, maternal CD4 < 250, infant HIV status, less breastfeeding, low birth weight, non-vaginal delivery, and infant gestational age were significant risk factors for underweight and stunting.</p> <p>Conclusion</p> <p>Baseline stunting and underweight was high in both HIV-infected and uninfected infants; growth indices diverged early and were impacted by timing of infection and SWEN prophylaxis. Early growth monitoring of all HIV-exposed infants is an important low-cost strategy for improving health and survival outcomes of these infants.</p> <p>Trial Registration</p> <p>NCT00061321</p> |
| first_indexed | 2024-12-17T00:03:07Z |
| format | Article |
| id | doaj.art-9e169c1502524c369d6bacaba01be8f9 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-17T00:03:07Z |
| publishDate | 2012-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-9e169c1502524c369d6bacaba01be8f92022-12-21T22:11:02ZengBMCBMC Infectious Diseases1471-23342012-10-0112128210.1186/1471-2334-12-282Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, IndiaRam MalathiGupte NikhilNayak UmaKinikar Aarti AKhandave MangeshShankar Anita VSastry JayagowriBollinger Robert CGupta Amita<p>Abstract</p> <p>Background</p> <p>India has among the highest rates of infant malnutrition. Few studies investigating the growth patterns of HIV-exposed infants in India or the impact of timing of HIV infection on growth in settings such as India exist.</p> <p>Methods</p> <p>We used data from the Six Week Extended Nevirapine (SWEN) trial to compare the growth patterns of HIV-infected and HIV-exposed but uninfected infants accounting for timing of HIV infection, and to identify risk factors for stunting, underweight and wasting. Growth and timing of HIV infection were assessed at weeks 1, 2, 4, 6, 10, 14 weeks and 6, 9, 12 months of life. Random effects multivariable logistic regression method was used to assess factors associated with stunting, underweight and wasting.</p> <p>Results</p> <p>Among 737 HIV-exposed infants, 93 (13%) were HIV-infected by 12 months of age. Among HIV-infected and uninfected infants, baseline prevalence of stunting (48% vs. 46%), underweight (27% vs. 26%) and wasting (7% vs. 11%) was similar (p>0.29), but by 12 months stunting and underweight, but not wasting, were significantly higher in HIV-infected infants (80% vs. 56%, 52% vs. 29%, p< 0.0001; 5% vs. 6%, p=0.65, respectively). These differences rapidly manifested within 4–6 weeks of birth. Infants infected in utero had the worst growth outcomes during the follow-up period. SWEN was associated with non-significant reductions in stunting and underweight among HIV-infected infants and significantly less wasting in HIV-uninfected infants. In multivariate analysis, maternal CD4 < 250, infant HIV status, less breastfeeding, low birth weight, non-vaginal delivery, and infant gestational age were significant risk factors for underweight and stunting.</p> <p>Conclusion</p> <p>Baseline stunting and underweight was high in both HIV-infected and uninfected infants; growth indices diverged early and were impacted by timing of infection and SWEN prophylaxis. Early growth monitoring of all HIV-exposed infants is an important low-cost strategy for improving health and survival outcomes of these infants.</p> <p>Trial Registration</p> <p>NCT00061321</p>http://www.biomedcentral.com/1471-2334/12/282HIV-exposed infantsGrowth patternsIndiaExtended use of nevirapineRisk factorsTiming of HIV Infection |
| spellingShingle | Ram Malathi Gupte Nikhil Nayak Uma Kinikar Aarti A Khandave Mangesh Shankar Anita V Sastry Jayagowri Bollinger Robert C Gupta Amita Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India BMC Infectious Diseases HIV-exposed infants Growth patterns India Extended use of nevirapine Risk factors Timing of HIV Infection |
| title | Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India |
| title_full | Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India |
| title_fullStr | Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India |
| title_full_unstemmed | Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India |
| title_short | Growth patterns among HIV-exposed infants receiving nevirapine prophylaxis in Pune, India |
| title_sort | growth patterns among hiv exposed infants receiving nevirapine prophylaxis in pune india |
| topic | HIV-exposed infants Growth patterns India Extended use of nevirapine Risk factors Timing of HIV Infection |
| url | http://www.biomedcentral.com/1471-2334/12/282 |
| work_keys_str_mv | AT rammalathi growthpatternsamonghivexposedinfantsreceivingnevirapineprophylaxisinpuneindia AT guptenikhil growthpatternsamonghivexposedinfantsreceivingnevirapineprophylaxisinpuneindia AT nayakuma growthpatternsamonghivexposedinfantsreceivingnevirapineprophylaxisinpuneindia AT kinikaraartia growthpatternsamonghivexposedinfantsreceivingnevirapineprophylaxisinpuneindia AT khandavemangesh growthpatternsamonghivexposedinfantsreceivingnevirapineprophylaxisinpuneindia AT shankaranitav growthpatternsamonghivexposedinfantsreceivingnevirapineprophylaxisinpuneindia AT sastryjayagowri growthpatternsamonghivexposedinfantsreceivingnevirapineprophylaxisinpuneindia AT bollingerrobertc growthpatternsamonghivexposedinfantsreceivingnevirapineprophylaxisinpuneindia AT guptaamita growthpatternsamonghivexposedinfantsreceivingnevirapineprophylaxisinpuneindia |