{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:02:13Z","timestamp":1788447733892,"version":"build-2803163510"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["U105960371"],"award-info":[{"award-number":["U105960371"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Gates Cambridge Scholarship at the University of Cambridge"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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\u00a0mo in Ugandan CHEU, exposed to maternal HIV and TDF-containing ART in utero and via breastmilk (n\u2009=\u200985), and CHUU peers (n\u2009=\u200980). The groups had similar weight and length 2\u00a0wk after birth (WK2), but, despite higher exclusive breastfeeding rates, CHEU had slower growth by WK14 and ~0.5\u00a0kg 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\u2009=\u2009.03 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\u2009&amp;lt;\u2009.001) coinciding with higher maternal CTX concentrations, and at WK78 (+45.6 (28.9)%, p\u2009&amp;lt;\u2009.05). These findings suggest early onset growth deficits and altered bone metabolism in CHEU by 3\u00a0mo 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.<\/jats:p>","DOI":"10.1093\/jbmr\/zjag024","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T12:27:15Z","timestamp":1770035235000},"page":"823-836","source":"Crossref","is-referenced-by-count":2,"title":["Longitudinal comparison of bone, growth, and biochemical markers in breastfed HIV-exposed uninfected and HIV-unexposed Ugandan children"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0078-0284","authenticated-orcid":false,"given":"Florence","family":"Nabwire","sequence":"first","affiliation":[{"name":"MRC Epidemiology Unit, University of Cambridge , Cambridge CB2 0SL ,","place":["United Kingdom"]},{"name":"MRC Nutrition and Bone Health Research Group , University of Cambridge ,","place":["Cambridge CB2 0AH, United Kingdom"]},{"name":"Formerly based at the MRC Elsie Widdowson Laboratory , Cambridge CB1 9NL ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1277-819X","authenticated-orcid":false,"given":"Matthew M","family":"Hamill","sequence":"additional","affiliation":[{"name":"MRC Nutrition and Bone Health Research Group , University of Cambridge ,","place":["Cambridge CB2 0AH, United Kingdom"]},{"name":"Formerly based at the MRC Elsie Widdowson Laboratory , Cambridge CB1 9NL ,","place":["United Kingdom"]},{"name":"School of Medicine, Johns Hopkins University , Baltimore, MD 21202 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Glenn","family":"Fowler","sequence":"additional","affiliation":[{"name":"School of Medicine, Johns Hopkins University , Baltimore, MD 21202 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeodata","family":"Kekitiinwa","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children\u2019s Foundation-Uganda (Baylor-Uganda) , Block 5, Mulago Hospital. 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