ArticleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2026
Longitudinal comparison of bone, growth, and biochemical markers in breastfed HIV-exposed uninfected and HIV-unexposed Ugandan children.
Article in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Bone health across the lifespan in African populations affected by HIV.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026Article
- Article
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6 authors.
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Abstract
Due to successful maternal antiretroviral therapy (ART), pediatric HIV infections have declined, leading to a growing population of children HIV-exposed uninfected (CHEU) in Sub-Saharan Africa. However, studies report poorer growth and development in CHEU vs children HIV-unexposed uninfected (CHUU), raising concerns about maternal HIV and ART exposure, particularly tenofovir disoproxil fumarate (TDF). This analysis of data from the Gumba study compares growth trajectories, bone mineral accretion, and biochemical markers of growth and bone metabolism to age 18 mo in Ugandan CHEU, exposed to maternal HIV and TDF-containing ART in utero and via breastmilk (n = 85), and CHUU peers (n = 80). The groups had similar weight and length 2 wk after birth (WK2), but, despite higher exclusive breastfeeding rates, CHEU had slower growth by WK14 and ~0.5 kg lower body weight and fat mass by WK26. Growth faltering occurred in both groups from WK26, with widening differences: by WK78, 59% of CHEU were stunted compared to 33% of CHUU. Children HIV-exposed uninfected had lower whole-body (WB) BMC and bone area at WK14 and WK26 (p = .03 and .0003 for interaction, respectively), but similar WB areal BMD before and after size adjustment, indicating accrued bone mineral was appropriate for their slower growth. There were no group differences in biochemical markers of growth or bone formation. However, CHEU had higher C-terminal telopeptide (CTX), a marker of bone resorption, at WK14 (group difference (95% CI): +50.9 (24.1)%, p < .001) coinciding with higher maternal CTX concentrations, and at WK78 (+45.6 (28.9)%, p < .05). These findings suggest early onset growth deficits and altered bone metabolism in CHEU by 3 mo of age, possibly linked to the TDF-containing ART initiated during pregnancy and/or disruptions in bone metabolism observed in their mothers. Further studies are needed to investigate the mechanisms and long-term implications for growth and bone health in CHEU.
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