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Growth of Infants Born to HIV-Infected Women: South Africa Perspectives

  • Peter A. Cooper
Chapter

Abstract

The growth of infants born to HIV-infected women is influenced by the timing of the infection, namely, whether infection occurs during intrauterine life, around the time of delivery or postnatally via breastfeeding. Most data suggest that babies of HIV-positive women have a modest reduction in both birth weight and gestation. These effects are largely seen in developing countries, though there are some data to suggest that these effects are limited to those infected during intrauterine life. Many factors are responsible for suboptimal growth during postnatal life in HIV-infected infants and children. These include both the direct effects of HIV infection as well as the complications as a result of immune deficiency. Longitudinal studies show that HIV-infected infants have modest reductions in weight gain and linear growth when compared to uninfected infants, but that weight-for-length is usually normal or only mildly affected. Most studies suggest that infants born to mothers infected with HIV but themselves not infected have similar growth patterns to infants born to HIV-negative mothers, but, in developing countries, parental illness and social disruption associated with HIV may result in suboptimal growth. Studies on uninfected infants born to HIV-positive mothers who are not breast fed suggest that they may benefit from a formula with added probiotics. Symptomatic HIV-infected infants attending HIV clinics or requiring admission to hospital are frequently more severely malnourished and also manifest with suboptimal head growth as well. Neurodevelopmental delay is frequent in such infants. Recent data have shown a dramatic improvement in mortality and morbidity when antiretroviral therapy is started in HIV-infected infants during the first 3 months of life regardless of the disease stage and future studies will provide data on growth and development of infants who commence early therapy. The long-term goal remains effective prevention of mother-to-child transmission of HIV.

Keywords

Head Circumference Severe Acute Malnutrition Intrauterine Life South African Study European Collaborative Study 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

ACTH

Adrenocorticotrophic hormone

HAART

Highly active antiretroviral therapy

HIV

Human immunodeficiency virus

MDI

Mental developmental index

PDI

Psychomotor developmental index

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of PaediatricsUniversity of the WitwatersrandJohannesburgSouth Africa
  2. 2.Charlotte Maxeke Johannesburg Academic HospitalJohannesburgSouth Africa

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