生命最初 23 个月期间的身体成分轨迹因肯尼亚西部婴儿的 HIV 暴露而异：一项前瞻性研究。
Body Composition Trajectories During the First 23 Months of Life Differ by HIV Exposure Among Infants in Western Kenya: A Prospective Study.
机构信息
Department of Nutritional Sciences, University of Texas, Austin, TX, USA.
International Initiative for Impact Evaluation Inc (3ie), Washington, DC, USA.
出版信息
J Nutr. 2023 Jan;153(1):331-339. doi: 10.1016/j.tjnut.2022.11.010. Epub 2022 Dec 21.
BACKGROUND
Infants who are HIV-exposed and uninfected have suboptimal growth patterns compared to those who are HIV-unexposed and uninfected. However, little is known about how these patterns persist beyond 1 year of life.
OBJECTIVES
This study aimed to examine whether infant body composition and growth trajectories differed by HIV exposure during the first 2 years of life among Kenyan infants using advanced growth modeling.
METHODS
Repeated infant body composition and growth measurements (mean: 6; range: 2-7) were obtained from 6 weeks to 23 months in the Pith Moromo cohort in Western Kenya (n = 295, 50% HIV-exposed and uninfected, 50% male). Body composition trajectory groups were fitted using latent class mixed modeling (LCMM) and associations between HIV exposure and growth trajectories were examined using logistic regression analysis.
RESULTS
All infants exhibited poor growth. However, HIV-exposed infants generally grew suboptimally than unexposed infants. Across all body composition models except for the sum of skinfolds, HIV-exposed infants had a higher likelihood of belonging to the suboptimal growth groups identified by LCMM than the HIV-unexposed infants. Notably, HIV-exposed infants were 3.3 times more likely (95% CI: 1.5-7.4) to belong to the length-for-age z-score growth class that remained at a z-score of < -2, indicating stunted growth. HIV-exposed infants were also 2.6 times more likely (95% CI: 1.2-5.4) to belong to the weight-for-length-for-age z-score growth class that remained between 0 and -1, and were 4.2 times more likely (95% CI: 1.9-9.3) to belong to the weight-for-age z-score growth class that indicated poor weight gain besides stunted linear growth.
CONCLUSIONS
In a cohort of Kenyan infants, HIV-exposed infants grew suboptimally compared to HIV-unexposed infants beyond 1 year of age. These growth patterns and longer-term effects should be further investigated to support the ongoing efforts to reduce early-life HIV exposure-related health disparities.
背景
与未感染 HIV 的未暴露婴儿相比，HIV 暴露但未感染的婴儿生长模式较差。然而，对于这些模式在 1 岁以后如何持续，人们知之甚少。
目的
本研究旨在通过先进的生长模型，检查在肯尼亚婴儿中，在生命的前 2 年中，HIV 暴露是否会影响婴儿的身体成分和生长轨迹。
方法
在肯尼亚西部的皮思莫罗莫队列中，从 6 周龄到 23 个月龄，对 295 名婴儿（50% HIV 暴露但未感染，50%为男性）进行了重复的婴儿身体成分和生长测量（平均值：6；范围：2-7）。使用潜在类别混合建模（LCMM）拟合身体成分轨迹组，并使用逻辑回归分析检查 HIV 暴露与生长轨迹之间的关联。
结果
所有婴儿的生长均较差。然而，与未暴露的婴儿相比，HIV 暴露的婴儿通常生长欠佳。除了皮褶厚度总和之外，在所有身体成分模型中，与未暴露的婴儿相比，HIV 暴露的婴儿更有可能属于 LCMM 确定的生长不理想的组。值得注意的是，HIV 暴露的婴儿属于长度年龄 z 分数生长类别（z 分数< -2，表明生长迟缓）的可能性是未暴露婴儿的 3.3 倍（95%CI：1.5-7.4）。HIV 暴露的婴儿也更有可能属于体重长度年龄 z 分数生长类别（0 到-1 之间），其可能性是未暴露婴儿的 2.6 倍（95%CI：1.2-5.4），而属于体重年龄 z 分数生长类别的可能性是未暴露婴儿的 4.2 倍（95%CI：1.9-9.3），表明除了生长迟缓之外，体重增加不良。
结论
在肯尼亚婴儿队列中，与未暴露于 HIV 的婴儿相比，HIV 暴露的婴儿在 1 岁后生长欠佳。应进一步研究这些生长模式和长期影响，以支持减少与早期 HIV 暴露相关的健康差异的持续努力。
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