title: Growth at 2 Years of Age in HIV-exposed Uninfected Children in the United States by Trimester of Maternal Antiretroviral Initiation.
abstract: Abnormal childhood growth may affect future health. Maternal tenofovir (TFV) use was associated with lower body length and head circumference at 1 year of age in HIV-exposed uninfected (HEU) US children.
  
  
  
  We studied 509 HEU children in the US-based Surveillance Monitoring of Antiretroviral Therapy Toxicities cohort whose HIV-infected mothers were not using antiretrovirals at the last menstrual period and began combination antiretroviral therapy (cART) in pregnancy (cART initiators). We examined adjusted associations between antiretrovirals and Centers for Disease Control 2000 growth Z scores at 2 years of age within trimester of cART initiation: weight (weight Z score), length (length Z score), weight-for-length [weight-for-length Z score (WFLZ)], triceps skinfold Z score (TSFZ) and head circumference (head circumference Z score).
  
  
  
  Mothers mean age was 28.6 years; 57% were black non-Hispanic and 19% delivered at <37 weeks gestation. At 2 years, mean weight Z score, length Z score, WFLZ and head circumference Z score were above average (P < 0.05), whereas TSFZ (P = 0.57) did not differ from average. WFLZ was >1.64 standard deviation (SD) (>95th percentile) in 13%. Among children of first-trimester cART initiators, TFV+emtricitabine-exposed children had slightly higher mean WFLZ (0.45 SD; 95% confidence interval: -0.10 to 1.00) and lower TSFZ (-0.55 SD; 95% confidence interval: -1.07 to -0.02) compared with zidovudine+lamivudine-exposed children. TSFZ was lower in those exposed to boosted protease inhibitors. In contrast, growth in children of second trimester cART initiators did not differ by antiretroviral exposures.
  
  
  
  Growth was above average in HEU; 13% were obese. Maternal TFV use was not associated with lower length or head circumference at 2 years of age, as hypothesized, but may be related to greater weight among those exposed to cART early in pregnancy.
authors: From the *Department of Pediatrics, Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, and †Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; ‡Department of Pediatrics, The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, California; §Maternal and Pediatric Infectious Disease (MPID) Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; ¶Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana; ‖Department of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama; **Department of Pediatrics, University of Florida, Jacksonville, Florida; ††Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania; ‡‡Department of Pediatrics, Children's Hospital Colorado, Denver, Colorado; §§Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana; ¶¶Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois; ‖‖Department of Pediatrics, New York University Langone Medical Center, New York, New York; and ***Division of Pediatric Clinical Research, Department of Pediatrics, Miller School of Medicine at the University of Miami, Miami, Florida.
authors: Denise L
authors: DL
authors: Jacobson
authors: Kunjal
authors: K
authors: Patel
authors: Paige L
authors: PL
authors: Williams
authors: Mitchell E
authors: ME
authors: Geffner
authors: George K
authors: GK
authors: Siberry
authors: Linda A
authors: LA
authors: DiMeglio
authors: Marilyn J
authors: MJ
authors: Crain
authors: Ayesha
authors: A
authors: Mirza
authors: Janet S
authors: JS
authors: Chen
authors: Elizabeth
authors: E
authors: McFarland
authors: Deborah
authors: D
authors: Kacanek
authors: Margarita
authors: M
authors: Silio
authors: Kenneth
authors: K
authors: Rich
authors: William
authors: W
authors: Borkowsky
authors: Russell B
authors: RB
authors: Van Dyke
authors: Tracie L
authors: TL
authors: Miller
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001827:Body Height; D001835:Body Weight; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D018811:Maternal Exposure / Q000706:statistics & numerical data; D009035:Mothers / Q000706:statistics & numerical data; D011446:Prospective Studies; D061665:Time-to-Treatment / Q000706:statistics & numerical data
chemical_list: D044966:Anti-Retroviral Agents