ArticlePloS one2026
Body composition of children born HIV-exposed uninfected in rural Zimbabwe.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGlobally, 15 million children were born HIV-exposed uninfected (CHEU) from mothers living with HIV. CHEU have increased mortality, morbidity and stunting compared to children HIV-unexposed (CHU). Our objective was to compare body composition between CHEU and CHU, which may underlie this vulnerability.
methodsIn a substudy among 223 children (36 CHEU and 187 CHU) enrolled in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe, we measured height, knee-heel length, weight, calf circumference, skinfold thicknesses (triceps, subscapular and calf), and bio-electrical impedance at 2 years of age. Generalised estimating equations were used to compare body composition between CHEU and CHU, and interactions with linear growth and birthweight.
resultsCHEU had significantly lower length-for-age, knee-heel length, weight-for-age, mid-upper arm circumference and calf circumference compared to CHU. CHEU had a lower impedance index (adjusted mean difference -0.49, 95% CI -0.87, -0.11), reflecting less lean mass, and lower skinfold thicknesses (subscapular Z-score adjusted mean difference -0.49 (95% CI -0.97, -0.02); triceps Z-score -0.48 (95% CI -0.83, -0.13)), indicating reduced subcutaneous fat. In early-life, CHEU had lower birthweight. However, no significant interaction between stunting or birthweight and HIV exposure was observed for body composition outcomes.
conclusionCHEU have a distinct pattern of body composition by 2 years of age, characterised by reduced lean and fat mass compared to CHU which was not explained by reduced linear growth or lower birthweight. This pattern of early-life growth may contribute to the increased vulnerability of CHEU to mortality, morbidity and reduced neurodevelopment.
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