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HIV

Growth Outcomes in HIV-Exposed and Uninfected Children in South Africa

Strategic Insights

— 1 min read

Research conducted by the University of the Witwatersrand in Johannesburg, South Africa, has found that children who are HIV-exposed and uninfected (CHEU) have similar growth outcomes to those who are HIV-unexposed and uninfected (CHUU) up to 2 years of age. However, the study revealed high prevalence of stunting in both groups, with CHEU showing a slightly higher risk of stunting, underweight, and wasting at 1 year of age. The research also found that CHEU had lower risk of overweight at 2 years of age.

Key Takeaways:

  • The study involved a prospective cohort of 398 children (143 CHEU, 255 CHUU) at 1 year of age and 286 children (82 CHEU, 204 CHUU) at 2 years of age.
  • CHEU and CHUU had similar growth outcomes, with no statistically significant differences in length-for-age (LAZ), weight-for-age (WAZ), weight-for-length (WLZ), and head circumference-for-age (HCAZ) scores between the two groups.
  • The prevalence of stunting was high in both groups, with CHEU having a higher risk of stunting, underweight, and wasting at 1 year of age, but not significant in analyses adjusted for maternal and child factors.
  • CHEU had lower risk of overweight at 2 years of age.
  • The study's limitations include limited data on maternal ART and infant breastfeeding, which may have introduced residual confounding.
  • Future studies should aim to identify children at risk of growth impairment to develop targeted interventions for optimizing growth and healthy development.

Statistics:

  • 398 children (143 CHEU, 255 CHUU) were followed up at 1 year of age.
  • 286 children (82 CHEU, 204 CHUU) were followed up at 2 years of age.
  • The prevalence of stunting at 1 year was 29.3% (95% CI: 22.4%, 37.3%) in CHEU and 19.4% (95% CI: 15.0%, 24.8%) in CHUU.
  • The prevalence of stunting at 2 years was 18.8% (95% CI: 11.7%, 28.7%) in CHEU and 20.5% (95% CI: 15.5%, 26.6%) in CHUU.
  • The risk of stunting, underweight, and wasting was higher in CHEU at 1 year of age, but not significant in analyses adjusted for maternal and child factors.

Sources:

  • Comparative growth of children who are HIV-exposed and uninfected with those who are HIV-unexposed and uninfected at age 1 and 2 years in South Africa: a prospective cohort study. eClinicalMedicine, 2025;89:103515.
  • AIDS Weekly. October 20, 2025; p 167.

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