ArticleAIDS (London, England)2020
Inflammation, cytomegalovirus and the growth hormone axis in HIV-exposed uninfected Zimbabwean infants.
Article in AIDS (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 9 citations in OpenAlex.
- In-utero HIV exposure and postnatal growth to 8 years of age: a prospective cohort study in the Western Cape, South Africa.The Lancet. Child & adolescent health · 2026Article
- Article
- Impaired clinical, biological, and cytokine patterns in HIV-1 exposed uninfected newborns in Yaoundé: A comparative study of neonatal immune vulnerability.African journal of laboratory medicine · 2026Article
- Poorer Longitudinal Growth Among HIV Exposed Compared With Unexposed Infants in Kenya.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Neurodevelopmental Risk in HIV-Exposed Uninfected Children: Call for Developmental Surveillance.Journal of pediatrics, perinatology and child health · 2025Article
- A 12-month Prospective Study of HIV-infected and HIV-uninfected Women and Their Infants in Malawi: Comparative Analysis of Clinical Events and Infant Growth.The American journal of tropical medicine and hygiene · 2023Article
- Polyunsaturated Fatty Acid Composition in Breast Milk Plasma of HIV-infected and Uninfected Mothers in Relation to Infant Clinical Outcomes.Nutrition and metabolic insights · 2022Article
- Growth Trajectories of HIV Exposed and HIV Unexposed Infants. A Prospective Study in Gweru, Zimbabwe.Global pediatric health · 2021Article
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
Abstract
objectivesDespite avoiding HIV infection, HIV-exposed uninfected (HEU) infants have poorer clinical outcomes than HIV-unexposed infants, including impaired growth. The growth hormone (GH) axis is an important regulator of infant growth through hepatic synthesis of insulin-like growth-factor-1 (IGF-1), and may be disrupted by chronic inflammation and acute infections, including cytomegalovirus (CMV). We tested the hypothesis that these factors lead to disruption of the GH axis in HEU infants, which might contribute to their impaired growth.
designSubstudy of 343 infants from the ZVITAMBO trial in Harare, Zimbabwe.
methodsIGF-1, growth parameters, C-reactive protein (CRP) and CMV viraemia were evaluated in 243 HEU infants and 100 HIV-unexposed infants. Univariable linear and logistic regression models were used to determine associations between IGF-1 and growth parameters, CRP and CMV.
resultsMean 6-week IGF-1 was significantly lower in HEU compared with HIV-unexposed infants (29.6 vs. 32.6 ng/ml; P = 0.014), and associated with subsequent linear and ponderal growth through 6 months of age. CRP was inversely correlated with IGF-1 in all infants regardless of HIV exposure status (β = -0.84; P = 0.03). CMV viral loads were inversely correlated with IGF-1 in HEU (β = -1.16; P = 0.008) but not HIV-unexposed (β = 0.21; P = 0.83) infants.
conclusionOverall, we found evidence for greater disruption of the GH axis in HEU compared with HIV-unexposed infants as early as 6 weeks of age, suggesting a role for reduced IGF-1 in mediating growth impairment in HEU infants. Inflammation and coinfections may be drivers of growth impairment in HEU infants by disrupting the GH axis.
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