Institute of Global Health, University of Geneva, Geneva, Switzerland.
Baobab Health Trust, Lilongwe, Malawi.
AIDS. 2018 Sep 24;32(15):2201-2208. doi: 10.1097/QAD.0000000000001942.
To compare birth weight and weight gain in HIV-exposed, uninfected (HEU) infants up to 24 months old, who enrolled in the Malawian national HIV care clinic (HCC) programme either before or after Option B+ (OB+) was implemented.
DESIGN, SETTING AND PARTICIPANTS: HIV-exposed infants enrol in the HCC programme as soon as possible after birth and are followed up to at least 24 months old. This analysis includes HEU infants with recorded birth weight, date of birth, gender and at least one follow-up weight measurement from 21 health facilities in central and southern Malawi (January 2010-December 2014). Weight-for-age z scores (WAZ) were derived and compared by birth period using linear regression at birth and mixed effects models for postnatal weight gain up to 24 months old.
Of 6845 HEU infants included in this study, 88.5% were born after OB+. The proportion of infants exposed in utero to combination antiretroviral therapy (ART) significantly increased after OB+ was implemented, and infants were exposed to ART for a longer time. There was no significant difference in WAZ at birth (P = 0.654) among HEU infants by birth period, but postnatal weight gain was faster among HEU infants born in the Option B+ period than infants born pre-Option B+.
Birth weight was not affected by longer exposure to ART during pregnancy after OB+ was introduced, when weight gain in HEU infants was faster, possibly because their mothers were in better health.
比较在马拉维国家艾滋病毒护理诊所（HCC）方案中登记的、在实施选项 B+（OB+）之前或之后的 HIV 暴露但未感染（HEU）婴儿在 24 个月龄时的出生体重和体重增加情况。
设计、地点和参与者：HIV 暴露婴儿在出生后尽快登记到 HCC 方案中，并至少随访至 24 个月龄。本分析包括在马拉维中部和南部的 21 个卫生机构中，有记录的出生体重、出生日期、性别和至少一次随访体重测量值的 HEU 婴儿（2010 年 1 月至 2014 年 12 月）。通过线性回归在出生时获得体重与年龄比值（WAZ）并进行比较，在出生后通过混合效应模型比较在 24 个月龄时的体重增加情况。
本研究纳入的 6845 名 HEU 婴儿中，88.5%是在 OB+后出生的。OB+实施后，胎儿暴露于联合抗逆转录病毒疗法（ART）的婴儿比例显著增加，且婴儿暴露于 ART 的时间更长。但根据出生时期，HEU 婴儿的 WAZ 在出生时无显著差异（P=0.654），但在 OB+后出生的 HEU 婴儿的体重增加速度比 OB+前出生的婴儿快。
OB+实施后，当 HEU 婴儿的体重增加更快时，出生体重并未受到妊娠期间更长时间暴露于 ART 的影响，这可能是因为其母亲的健康状况更好。
