Costa Priscila R F, Guimarães Nathalia S, Lira Carlos R N, Leite Luana O, de Cássia Ribeiro da Silva Rita, Barreto Maurício L, Paixão Enny S
Department of Science Nutrition, Federal University of Bahia, 32 Araujo Pinho Avenue, Salvador, 40.110-907, Brazil.
Post-Graduation Program in Food, Nutrition and Health, Federal University of Bahia, Salvador, Brazil.
BMC Public Health. 2025 Feb 21;25(1):717. doi: 10.1186/s12889-025-21838-w.
Approximately 1.3 million pregnancies are exposed to HIV perinatally each year, with transmission rates ranging from 4 to 21%, despite 85% antiretroviral therapy (ART) coverage among pregnant women. While ART has significantly reduced mother-to-child transmission, recent studies indicate an increased risk of chronic conditions among perinatally HIV-infected youth. There is a critical need for further research on the growth and health of these populations to inform effective health interventions. Therefore, the aim of this study is to critically evaluate observational research assessing the growth and body composition of perinatally HIV-infected adolescents and young adults.
We conducted a systematic review using the MEDLINE (by PubMed), Embase, Central (by Cochrane Library), Latin American and Caribbean Health Science Information (LILACS) and Web of Science databases. The initial search was conducted on November 24, 2022, and updated on June 3, 2024. We included cohort studies that evaluated perinatally HIV-infected adolescents (aged 10 to 19 years) and young adults (aged 20 to 24 years). A meta-analysis was performed to estimate the prevalence of stunting (HAZ < -2) and underweight (BAZ < -2). Additionally, we conducted meta-analyses for the mean values of HAZ and BAZ in the population after the follow-up period, as well as for the mean change in HAZ and BAZ post-follow-up.
Our search strategy retrieved 11,017 documents. After excluding duplicates, we analyzed 9,273 titles and abstracts. A full-text review of the remaining 87 records was conducted. Following the updated search, we identified 6 publications from 4 studies, resulting in a total of 14 studies and 16 publications. Nine studies focused exclusively on adolescents, while three evaluated both children and adolescents, and three included both adolescents and young adults. We estimated a prevalence of stunting at 26% (95% CI: 0.23-0.29) and underweight at 14% (95% CI: 0.12-0.17). In this population, the mean HAZ was -1.58 (95% CI: -1.90; -1.27), and the mean BAZ was -0.34 (95% CI: -0.61; -0.06). Additionally, we identified an increase of 0.55 (95% CI: 0.07; 1.03) in mean HAZ and 0.12 (95% CI: -0.56; 0.79) in mean BAZ after the follow-up period.
Our study highlights significant growth and body composition challenges among perinatally HIV-infected adolescents and young adults, with concerning rates of stunting and underweight. Although there was a modest increase in height-for-age, persistent challenges in achieving optimal growth remain. The slight improvement in BMI is insufficient to fully address underweight concerns. The limited number of studies and their inherent limitations restrict the ability to draw consistent conclusions regarding the effects and magnitude of exposure on anthropometric outcomes. Further research is needed to better elucidate these relationships.
CRD42022372837.
每年约有130万例妊娠在围产期暴露于艾滋病毒，尽管孕妇抗逆转录病毒疗法（ART）的覆盖率达85%，但传播率仍在4%至21%之间。虽然抗逆转录病毒疗法显著降低了母婴传播率，但最近的研究表明，围产期感染艾滋病毒的青少年患慢性病的风险有所增加。迫切需要对这些人群的生长发育和健康状况进行进一步研究，为有效的健康干预措施提供依据。因此，本研究的目的是严格评估观察性研究，以评估围产期感染艾滋病毒的青少年和青年的生长发育和身体成分。
我们使用MEDLINE（通过PubMed）、Embase、Central（通过Cochrane图书馆）、拉丁美洲和加勒比健康科学信息库（LILACS）以及科学网数据库进行了系统综述。初始检索于2022年11月24日进行，并于2024年6月3日更新。我们纳入了评估围产期感染艾滋病毒的青少年（10至19岁）和青年（20至24岁）的队列研究。进行荟萃分析以估计发育迟缓（身高别年龄Z评分[HAZ]＜-2）和体重不足（体重别年龄Z评分[BAZ]＜-2）的患病率。此外，我们对随访期后人群中HAZ和BAZ的平均值，以及随访后HAZ和BAZ的平均变化进行了荟萃分析。
我们的检索策略检索到11,017篇文献。排除重复文献后，我们分析了9,273篇标题和摘要。对其余87篇记录进行了全文审查。在更新检索后，我们从4项研究中确定了6篇出版物，最终共有14项研究和16篇出版物。9项研究专门针对青少年，3项研究评估了儿童和青少年，3项研究纳入了青少年和青年。我们估计发育迟缓的患病率为26%（95%置信区间：0.23 - 0.29），体重不足的患病率为14%（95%置信区间：0.12 - 0.17）。在该人群中，平均HAZ为-1.58（95%置信区间：-1.90；-1.27），平均BAZ为-0.34（95%置信区间：-0.61；-0.06）。此外，我们发现随访期后平均HAZ增加了0.55（95%置信区间：0.07；1.03），平均BAZ增加了0.十二（95%置信区间：-0.56；0.79）。
我们的研究突出了围产期感染艾滋病毒的青少年和青年在生长发育和身体成分方面面临的重大挑战，发育迟缓和体重不足的发生率令人担忧。尽管年龄别身高有适度增加，但在实现最佳生长方面仍存在持续挑战。体重指数的轻微改善不足以完全解决体重不足问题。研究数量有限及其固有局限性限制了我们就暴露对人体测量结果的影响和程度得出一致结论的能力。需要进一步研究以更好地阐明这些关系。
CRD42022372837
