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A description of HIV-exposed uninfected infants in the IeDEA Southern Africa Cohort and an examination of growth outcomes
Includes bibliographical references.
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| Main Author: | |
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
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Department of Public Health and Family Medicine
2015
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| _version_ | 1867613313069744128 |
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| access_status_str | Open Access |
| author | Morden, Erna |
| author2 | Davies, Mary-Ann |
| author_browse | Davies, Mary-Ann Morden, Erna |
| author_facet | Davies, Mary-Ann Morden, Erna |
| author_sort | Morden, Erna |
| collection | Thesis |
| description | Includes bibliographical references. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/13248 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:34:08.683Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2015 |
| publishDateRange | 2015 |
| publishDateSort | 2015 |
| publisher | Department of Public Health and Family Medicine |
| publisherStr | Department of Public Health and Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/13248 A description of HIV-exposed uninfected infants in the IeDEA Southern Africa Cohort and an examination of growth outcomes Morden, Erna Davies, Mary-Ann Epidemiology Includes bibliographical references. Since the successful use of antiretroviral therapy for the prevention of mother-to-child transmission of human immunodeficiency virus (HIV), there has been a steady increase in the number of infants born to HIV-infected mothers who remain uninfected. The characteristics of these HIV-exposed uninfected infants are not well known, including growth and other health outcomes. The International Epidemiologic Databases to Evaluate AIDS Southern Africa (IeDEA-SA) research strategy 2011-2016 includes specific studies in pregnant women, infants, children and adolescents. This study addresses one of the IeDEA-SA objectives, namely to establish and describe a sub-cohort of HIV-infected pregnant women and their exposed infants. Part A, the protocol, includes background information on sites contributing to this cohort of HIV-exposed uninfected (HEU) infants. It also details the aims, objectives and methodology of this study. Part B, the literature review, discusses what is known about HIV-exposed uninfected infants to date. It includes maternal disease factors, the use of antiretroviral therapy and the association between feeding modality and growth, focussing on studies conducted on the African continent. Part C, the manuscript, details the methodology, results and their interpretation of longitudinal analysis of growth among HEU infants in the IeDEA-SA collaboration. This cohort of HEU infants included 2621 infants from two South African sites. The median birth WAZ was -0.65 (IQR -1.46; 0.0), 51% were male and there was a median of 2 visits per infant. The feeding modalities practised were as follows: 0.5% exclusive breastfeeding, 7.9% unknown breastfeeding exclusivity, 78.6% mixed breastfeeding and 10.6% formula feeding. Mothers with a CD4 <200 cells/μl delivered infants with a lower birth WAZ (adjusted ß -0.253 [95% CI -0.043; -0.072], p = 0.006) compared to mothers with a CD4 ≥500 cells/≧l. Similarly, iv mothers who did not receive antiretroviral (ARVs) drugs delivered infants with a lower birth WAZ (adjusted ß -0.49 [95% CI -0.78; -0.20], p = 0.001) compared to mothers who received antenatal ARVs. Antenatal maternal ARVs and CD4 cell count did not have an effect on postnatal growth. Mixed effects models using maximum likelihood estimation for the longitudinal analysis of growth showed that exposure to breast milk positively influenced growth, albeit the effect was small. Infants with a birth weight <2 500g (ß 0.069 [95% CI 0.061; 0.078], p <0.0001) experienced faster growth within the first 28 weeks of life compared to infants with a birth weight ≥2 500g. In this cohort of South African HEU infants, less severe maternal disease and the use of ARVs positively impacted birth weight. Mixed feeding was common, and any breastfeeding may have a positive effect on longitudinal growth. 2015-07-01T09:02:27Z 2015-07-01T09:02:27Z 2014 Master Thesis Masters MPH http://hdl.handle.net/11427/13248 eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Epidemiology Morden, Erna A description of HIV-exposed uninfected infants in the IeDEA Southern Africa Cohort and an examination of growth outcomes |
| thesis_degree_str | Master's |
| title | A description of HIV-exposed uninfected infants in the IeDEA Southern Africa Cohort and an examination of growth outcomes |
| title_full | A description of HIV-exposed uninfected infants in the IeDEA Southern Africa Cohort and an examination of growth outcomes |
| title_fullStr | A description of HIV-exposed uninfected infants in the IeDEA Southern Africa Cohort and an examination of growth outcomes |
| title_full_unstemmed | A description of HIV-exposed uninfected infants in the IeDEA Southern Africa Cohort and an examination of growth outcomes |
| title_short | A description of HIV-exposed uninfected infants in the IeDEA Southern Africa Cohort and an examination of growth outcomes |
| title_sort | description of hiv exposed uninfected infants in the iedea southern africa cohort and an examination of growth outcomes |
| topic | Epidemiology |
| url | http://hdl.handle.net/11427/13248 |
| work_keys_str_mv | AT mordenerna adescriptionofhivexposeduninfectedinfantsintheiedeasouthernafricacohortandanexaminationofgrowthoutcomes AT mordenerna descriptionofhivexposeduninfectedinfantsintheiedeasouthernafricacohortandanexaminationofgrowthoutcomes |