scholarly journals In Utero HIV Exposure and the Early Nutritional Environment Influence Infant Neurodevelopment: Findings from an Evidenced Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3375
Author(s):  
Marina White ◽  
Kristin L. Connor
Keyword(s):  
Hiv Infection ◽  
Early Life ◽  
Meta Analysis ◽  
In Utero ◽  
Nutrition Interventions ◽  
Neurodevelopmental Outcomes ◽  
Multivitamin Supplementation ◽  
Nutritional Environment ◽  
Hiv Exposure ◽  
Hiv Exposed

The developing brain is especially vulnerable to infection and suboptimal nutrition during the pre- and early postnatal periods. Exposure to maternal human immunodeficiency virus (HIV) infection and antiretroviral therapies (ART) in utero and during breastfeeding can adversely influence infant (neuro) developmental trajectories. How early life nutrition may be optimised to improve neurodevelopmental outcomes for infants who are HIV-exposed has not been well characterised. We conducted an up-to-date evidence review and meta-analysis on the influence of HIV exposure in utero and during breastfeeding, and early life nutrition, on infant neurodevelopmental outcomes before age three. We report that exposure to maternal HIV infection may adversely influence expressive language development, in particular, and these effects may be detectable within the first three years of life. Further, while male infants may be especially vulnerable to HIV exposure, few studies overall reported sex-comparisons, and whether there are sex-dependent effects of HIV exposure on neurodevelopment remains a critical knowledge gap to fill. Lastly, early life nutrition interventions, including daily maternal multivitamin supplementation during the perinatal period, may improve neurodevelopmental outcomes for infants who are HIV-exposed. Our findings suggest that the early nutritional environment may be leveraged to improve early neurodevelopmental trajectories in infants who have been exposed to HIV in utero. A clear understanding of how this environment should be optimised is key for developing targeted nutrition interventions during critical developmental periods in order to mitigate adverse outcomes later in life and should be a priority of future research.

scholarly journals in utero HIV exposure and the early nutritional environment influence neurodevelopment in infants before age three: findings from an evidenced review and meta-analysis.

2020 ◽  
Author(s):  
Marina White ◽  
Kristin L Connor
Keyword(s):  
Hiv Infection ◽  
Early Life ◽  
Meta Analysis ◽  
In Utero ◽  
Nutrition Interventions ◽  
Neurodevelopmental Outcomes ◽  
Maternal Hiv ◽  
Nutritional Environment ◽  
Maternal Hiv Infection ◽  
Hiv Exposure

The developing brain is especially vulnerable to infection and suboptimal nutrition during the pre- and early postnatal periods. Exposure to maternal HIV infection and antiretroviral therapies (ART) in utero and during breastfeeding can adversely influence infant (neuro)developmental trajectories. How early life nutrition may be optimised to improve neurodevelopmental outcomes for infants who are HIV/ART-exposed has not been well characterised. We conducted an up-to-date evidence review and meta-analysis on the influence of HIV exposure in utero and during breastfeeding, and early life nutrition, on infant neurodevelopmental outcomes before age three. We report that exposure to maternal HIV infection/ART may adversely influence expressive language development, in particular, and these effects may be detectable within the first three years of life. Further, while male infants may be especially vulnerable to HIV/ART exposure, few studies overall reported sex-comparisons, and whether there are sex-dependent effects of HIV exposure on neurodevelopment remains a critical knowledge gap to fill. Lastly, early life nutrition interventions, including daily maternal multivitamin supplementation during the perinatal period, may improve neurodevelopmental outcomes for infants who are HIV-exposed. Our findings suggest that the early nutritional environment may be leveraged to improve early neurodevelopmental trajectories in infants who have been exposed to HIV in utero. A clear understanding of how this environment should be optimised is key for developing targeted nutrition interventions during critical developmental periods in order to mitigate adverse outcome later in life, and should be a priority of future research.

Neurodevelopmental outcomes and in-utero antiretroviral exposure in HIV-exposed uninfected children

AIDS ◽  
2018 ◽  
Vol 32 (17) ◽  
pp. 2583-2592 ◽  
Author(s):  
Micah Piske ◽  
Matthew A. Budd ◽  
Annie Q. Qiu ◽  
Evelyn J. Maan ◽  
Laura J. Sauvé ◽  
...  
Keyword(s):  
In Utero ◽  
Neurodevelopmental Outcomes ◽  
Hiv Exposed ◽  
Exposed Uninfected

scholarly journals Effect of in utero exposure to HIV and antiretroviral drugs on growth in HIV-exposed uninfected children: a systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e023937 ◽  
Author(s):  
Gabriel L Ekali ◽  
Julie Jesson ◽  
Pascal B Enok ◽  
Valériane Leroy
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
In Utero ◽  
Antiretroviral Drugs ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Growth Disorders ◽  
Growth Impairment ◽  
Hiv Exposed ◽  
Exposed Uninfected

IntroductionHIV-exposed uninfected (HEU) children have higher morbidity and mortality compared with HIV unexposed uninfected children. Despite the fact that malnutrition contributes to about half of all infant deaths below 5 years of age in low-income and middle-income countries and that growth impairment has been reported in the HEU population, the spectrum of growth disorders associated with HIV and antiretroviral therapy (ART) exposure during the in utero and perinatal periods is yet to comprehensively summarised among the global HEU population. This protocol for a systematic review and meta-analysis aims to critically synthesise data concerning the prevalence of underweight, stunting and wasting at different ages in the global HEU population.Methods and analysisMedline, EMBASE, Cochrane Library, TOXLINE, WHO Global Index Medicus and the Web of Science will be searched for relevant articles published between 1 January 1989 and 1 December 2017 without language restriction. In addition, conference abstracts and reference lists of eligible papers and relevant review articles will be screened. Authors will screen and select studies, extract data, assess the risk of bias as well as studies individually for heterogeneity. Study-specific estimates will be pooled through a random-effects meta-analysis model for studies that are clinically homogeneous while funnel plots and Egger’s test will be used to detect publication bias. Results will be presented by ART availability period, country income levels and mode of breastfeeding.Ethics and disseminationEthical approval will not be required for this study because it will be based on published data. The final report of this study will be published in a peer-reviewed journal and presented at scientific conferences. This review will summarise the evidence and quantify the problem of growth impairment in HEU infants and so shed more light on our understanding of the higher morbidity and mortality in this growing population.PROSPERO registration numberCRD42018091762.

scholarly journals Parental, In Utero, and Early-Life Exposure to Benzene and the Risk of Childhood Leukemia: A Meta-Analysis

2015 ◽  
Vol 183 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Frolayne M. Carlos-Wallace ◽  
Luoping Zhang ◽  
Martyn T. Smith ◽  
Gabriella Rader ◽  
Craig Steinmaus
Keyword(s):  
Early Life ◽  
Childhood Leukemia ◽  
Meta Analysis ◽  
In Utero ◽  
Early Life Exposure

scholarly journals Prevalence of vertical HIV infection and its risk factors among HIV exposed infants in East Africa: a systematic review and meta-analysis

2020 ◽  
Vol 48 (1) ◽  
Author(s):  
Amare Belachew ◽  
Tilahun Tewabe ◽  
Gizat Abinet Malede
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Hiv Infection ◽  
East Africa ◽  
Meta Analysis ◽  
World Health ◽  
Hiv Exposed Infants ◽  
Pooled Prevalence ◽  
The World ◽  
Hiv Exposed

Abstract Background Human immunodeficiency virus (HIV) is one of the most important global health problems. More than one and half million of children are living with HIV in the world, and majority of them are found in sub-Saharan Africa. There are primary fragmented study findings, and no review was conducted with regard to vertical HIV infection in East Africa. Therefore, this review aimed to assess the prevalence of vertical HIV infection and its risk factors among HIV-exposed infants in East Africa. Main body Eligible studies were retrieved by relevant search terms in CINHAL, Pub-MED, Google Scholar, EMBASE, Web of Science, SCOPUS, Cochrane, African Journals Online databases, and Ethiopian University research repositories. Data were extracted with Microsoft Excel and analyzed with Stata version 11 software. The random effect model was used to estimate the pooled prevalence of vertical HIV infection in East Africa. The variation between studies was quantified with an I2 statistic test. Furthermore, sub-group and meta-regression analyses were done to identify the sources of heterogeneity between the studies. The publication bias was assessed by Egger test. This systematic review and meta-analysis have included a total of 33 research articles. The overall pooled prevalence of vertical HIV infection in East Africa was 7.68% with a 95% confidence interval [CI]: (6.23, 9.12) with a heterogeneity of I2 = 86.8 with a p value < 0.001. In subgroup analysis, the pooled prevalence of vertical HIV infection in cross-sectional studies was 6.58%, while in cohort studies were 9.37%. Mixed feeding, AOR = 6.22 (1.02, 11.41); home delivery, AOR = 2 (1.01, 3); mothers took ART less than 4 weeks, AOR = 1.92 (1.79, 2.06); and infants who have not received ARV prophylaxis, AOR = 2.02 (1.05, 2.98) were the associated factors for vertical HIV infection for exposed infants. Conclusions The pooled prevalence of the mother to child transmission of HIV is way more than the desired target of the World Health Organization, which is less than 5% in breastfeeding populations. Thus, strengthening the prevention of vertical HIV transmission, promotion of exclusive breastfeeding, timely initiation of ART prophylaxis for HIV exposed infants, encouragement of hospital delivery, and the start of ART at the time of diagnosis of every HIV-positive person may all reduce the transmission of vertical HIV infection.

scholarly journals Early-life factors, in-utero exposures and endometriosis risk: a meta-analysis

2020 ◽  
Vol 41 (2) ◽  
pp. 279-289
Author(s):  
Jessica Ottolina ◽  
Matteo Schimberni ◽  
Sofia Makieva ◽  
Ludovica Bartiromo ◽  
Teresa Fazia ◽  
...  
Keyword(s):  
Early Life ◽  
Meta Analysis ◽  
In Utero ◽  
Early Life Factors ◽  
In Utero Exposures

scholarly journals In Utero Efavirenz Exposure and Neurodevelopmental Outcomes in HIV-exposed Uninfected Children in Botswana

2019 ◽  
Vol 38 (8) ◽  
pp. 828-834 ◽  
Author(s):  
Adam R. Cassidy ◽  
Paige L. Williams ◽  
Jean Leidner ◽  
Gloria Mayondi ◽  
Gbolahan Ajibola ◽  
...  
Keyword(s):  
In Utero ◽  
Neurodevelopmental Outcomes ◽  
Hiv Exposed ◽  
Exposed Uninfected

scholarly journals How do maternal HIV infection and the early nutritional environment influence the development of infants exposed to HIV in utero?

2019 ◽  
Author(s):  
Marina White ◽  
Eleanor Duffley ◽  
Ute D. Feucht ◽  
Theresa Rossouw ◽  
Kristin L. Connor
Keyword(s):  
Hiv Infection ◽  
Food Insecurity ◽  
Infant Development ◽  
Dietary Diversity ◽  
In Utero ◽  
Nutrient Intakes ◽  
Increased Risk ◽  
Maternal Hiv ◽  
Nutritional Environment ◽  
Maternal Hiv Infection

AbstractMalnutrition and infectious disease often coexist in socially inequitable contexts. Malnutrition in the perinatal period adversely affects offspring development and lifelong non-communicable disease risk. Less is known about the effects of infectious disease exposure during critical windows of development and health, and links between in utero HIV-exposure in the absence of neonatal infection, perinatal nutritional environments, and infant development are poorly defined. In a pilot feasibility study at Kalafong Hospital, Pretoria, South Africa, we aimed to better understand relationships between maternal HIV infection and the early nutritional environment of in utero HIV exposed uninfected (HEU) infants. We also undertook exploratory analyses to investigate relationships between food insecurity and infant development. Mother-infant dyads were recruited after delivery and followed until 12 weeks postpartum. Household food insecurity, nutrient intakes and dietary diversity scores did not differ between mothers living with or without HIV. Maternal reports of food insecurity were associated with lower maternal nutrient intakes 12 weeks postpartum, and in infants, higher brain-to-body weight ratio at birth and 12 weeks of age, and attainment of fewer large movement and play activities milestones at 12 weeks of age, irrespective of maternal HIV status. Reports of worry about food runout were associated with increased risk of stunting for HEU, but not unexposed, uninfected infants. Our findings suggest that food insecurity, in a vulnerable population, adversely affects maternal nutritional status and infant development. In utero exposure to HIV may further perpetuate these effects, which has implications for early child development and lifelong human capital.

scholarly journals 2529. Child HIV Exposure and CMV Seroprevalence in Botswana: No Associations with 24-Month Growth and Neurodevelopment

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S879-S879
Author(s):  
Natasha Onalenna Moraka ◽  
Sikhulile Moyo ◽  
Maryanne Ibrahim ◽  
Gloria Mayondi ◽  
Jean Leidner ◽  
...  
Keyword(s):  
Child Growth ◽  
World Health ◽  
Neurodevelopmental Outcomes ◽  
Women Living With Hiv ◽  
Increased Risk ◽  
Z Scores ◽  
Hiv Exposure ◽  
Hiv Exposed ◽  
Living With Hiv ◽  
Cmv Status

Abstract Background HIV-exposed but uninfected (HEU) children are at increased risk for poorer growth outcomes compared with HIV-unexposed/uninfected (HUU) children. Mechanisms underlying the poorer growth and delays in development of HEU children compared HUU children are not fully understood. We sought to define the relationship between child CMV status and HIV− exposure status and determine if a correlation existed between CMV status and growth (and neurodevelopmental) outcomes by 24 months of age in Botswana. Methods We used existing data and samples from the observational Botswana Tshipidi study, pregnant women living with HIV (WLHIV) and those without HIV, as well as their infants were enrolled and followed prospectively through 2 years postpartum. We tested 18-month child plasma samples from all available children for anti-HCMV IgG. We evaluated the association between positive (vs. negative) child CMV status at 18 months, and child growth, using the World Health Organization’s Growth Standard adjusted for age and sex and neurodevelopment at 24 months of age, using the Bayley Scales of Child Development (BSID) III. Results Of 317 children tested for CMV IgG at 18 months, 215 (67.8%) tested positive. Significantly higher proportions of HUU children had positive CMV serology (82.6%) compared with HEU children (47.4%, P < 0.01); 96.7% of HUU vs. 10.5% of HEU children breastfed. Child CMV infection was not associated with head circumference, weight-for-age, weight-for-height, nor height-for-age z-scores at 24 months. BSID III scores in receptive and expressive language, fine and gross motor, and cognitive domains at 24 months of age also did not differ by child CMV status. Conclusion We observed high rates of CMV seropositivity in 18-month-old children in Botswana with significantly higher CMV seropositivity among HUU children likely owing to breastfeeding. Positive CMV serostatus was not associated with child growth or neurodevelopmental outcomes at 24 months. Disclosures All authors: No reported disclosures.

Sign in / Sign up

Export Citation Format

Share Document