Revista de SIDA e investigación clínica

Growth of Infants Born to HIV-Infected Women in Madurai, South India

Abstract

Poorana Ganga Devi Navaneethapandian, Mahalakshmi Rajendran, Ramesh K, Thiruvalluvan Elangovan, Sudha Subramanyan, Rajapandian Thanapandy, Prabhakaran Rathinam and Soumya Swaminathan

Objective: To compare the growth patterns of HIV-infected and HIV-exposed, uninfected infants. Methods: Design: Prospective cohort study. Setting: Clinic of National Institute for Research in Tuberculosis, Madurai located in the Governement Rajaji Hospital (GRH) campus. Participants: Infants born to HIV-infected women in GRH, Madurai between January 2006 to October 2008. Infants were excluded if they were too ill, or had congenital abnormalities. Intervention: Baseline socio-demographic details and feeding patterns were recorded. Clinical assessment, anthropometric measurement, complete blood count, CD4 and CD8 counts and DNA PCR testing were performed. Anthropometric assessments and immunology profile were repeated once in 3 months till 24 months of age. Main outcome: Rate of change of weight and CD4% in HIV exposed and infected infants. Results: Of 76 infants enrolled, 25 were found to be HIV-infected by DNA PCR and fourteen of them died (11 before their first birthday). Weight gain in HIV-infected infants was 0.144 kg ((95% CI: -0.237, -0.051), P=0.003) less per month compared to negative infants, after adjusting for age, gender and feeding practice. Similarly, when compared to HIV negative infants, the decline in CD4 percentage was 3.1% ((95% CI: -4.735, -1.461), P<0.001) more in HIV positive infants. Changes in height, CD4 count, head circumference and haemoglobin were not associated with HIV status. Conclusion: Growth faltering occurs early in life in HIV-infected infants and its identification is important for developing appropriate treatment and nutritional management strategies. Mortality is high in the absence of early antiretroviral treatment.