{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T01:47:43Z","timestamp":1762652863836,"version":"build-2065373602"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R33HD10301079"],"award-info":[{"award-number":["R33HD10301079"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["1R61HD103079"],"award-info":[{"award-number":["1R61HD103079"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Despite effective antiretroviral therapy (ART), children born to women living with HIV but who remain uninfected (CHEU) have poorer growth compared to children born to women living without HIV (CHU). Few studies have compared growth beyond early childhood. In a cross-sectional study, we enrolled CHEU and CHU aged 3\u201310\u2009years. Growth Z-scores were calculated using WHO growth standards (weight-for-age [WAZ], height-for-age [HAZ], body mass index [BMIZ] [5\u201310\u2009years], and head circumference-for-age [HCZ] [3\u20135\u2009years]). Growth faltering was defined as Z-scores of &amp;lt;\u22122 SDs. We compared CHEU\/CHU growth Z-scores and prevalence of growth faltering using generalized linear models and binomial regression, adjusting for sociodemographic characteristics. We enrolled 2001 CHEU and 200 CHU. The median age was similar in both categories. CHEU were more likely to be orphaned and vulnerable children (22%) and to have shorter breastfeeding period (12 vs. 24\u2009months). CHEU mothers were older, had fewer years of education, and were more likely to be single parents. Most CHEU mothers were on ART during pregnancy with the enrolled child. CHEU had significantly lower HAZ (adjusted mean difference [aMD] \u22120.41, 95% CI \u22120.66, \u22120.17, P\u2009=\u2009.001) and WAZ (aMD \u22120.25, 95% CI \u22120.43, \u22120.08, P\u2009=\u2009.005). CHEU had 1.7 times higher prevalence of stunting (HAZ &amp;lt;\u22122) in unadjusted models, which was attenuated after adjustment. There were no differences in BMIZ or HCZ. Older CHEU aged 3\u201310\u2009years had lower WAZ and HAZ scores than CHU. Poorer growth outcomes persisted after adjustment for socio-economic factors, suggesting a potential role of biological factors.<\/jats:p>","DOI":"10.1093\/tropej\/fmaf043","type":"journal-article","created":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T01:45:46Z","timestamp":1762652746000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparison of height-for-age and weight-for-age\n                    <i>Z<\/i>\n                    -scores between HIV-exposed and -unexposed children aged 3\u201310 years old"],"prefix":"10.1093","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7146-0088","authenticated-orcid":false,"given":"Marion","family":"Muranda","sequence":"first","affiliation":[{"name":"Research and Programs Department, Kenyatta National Hospital, P.O Box 20723-00202, Nairobi,","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen","family":"King\u2019e","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, University of Nairobi, P.O. Box 19676-00202, Nairobi,","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hellen","family":"Moraa","sequence":"additional","affiliation":[{"name":"Research and Programs Department, Kenyatta National Hospital, P.O Box 20723-00202, Nairobi,","place":["Kenya"]},{"name":"Department of Global Health, University of Washington , Seattle, WA 98104,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvin","family":"Onyango","sequence":"additional","affiliation":[{"name":"Research and Programs Department, Kenyatta National Hospital, P.O Box 20723-00202, Nairobi,","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhoda","family":"Oricho","sequence":"additional","affiliation":[{"name":"Research and Programs Department, Kenyatta National Hospital, P.O Box 20723-00202, Nairobi,","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jillian","family":"Neary","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington , Seattle, WA 98104,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4301-1573","authenticated-orcid":false,"given":"Grace","family":"John-Stewart","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington , Seattle, WA 98104,","place":["United States"]},{"name":"Department of Epidemiology, University of Washington , Seattle, WA 98104,","place":["United States"]},{"name":"Department of Medicine, University of Washington , Seattle, WA 98104,","place":["United States"]},{"name":"Department of Pediatrics, University of Washington , Seattle, WA 98104,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5510-462X","authenticated-orcid":false,"given":"Dalton","family":"Wamalwa","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, University of Nairobi, P.O. Box 19676-00202, Nairobi,","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine J","family":"McGrath","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington , Seattle, WA 98104,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Njuguna","sequence":"additional","affiliation":[{"name":"Research and Programs Department, Kenyatta National Hospital, P.O Box 20723-00202, Nairobi,","place":["Kenya"]},{"name":"Department of Global Health, University of Washington , Seattle, WA 98104,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"2025110820454196200_fmaf043-B1","author":"AIDSinfo | UNAIDS"},{"key":"2025110820454196200_fmaf043-B2","doi-asserted-by":"crossref","first-page":"e32677","DOI":"10.1097\/MD.0000000000032677","article-title":"Growth differences by school-age and adolescence according to in utero and peripartum antiretroviral therapy exposure among Ugandan children","volume":"102","author":"Awadu","year":"2023","journal-title":"Medicine (Baltimore)"},{"key":"2025110820454196200_fmaf043-B3","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1097\/INF.0000000000002238","article-title":"Compromised growth among HIV-exposed uninfected compared with unexposed children in Nigeria","volume":"38","author":"Jumare","year":"2019","journal-title":"Pediatr Infect Dis J"},{"key":"2025110820454196200_fmaf043-B4","doi-asserted-by":"crossref","first-page":"2333794X21990338","DOI":"10.1177\/2333794X21990338","article-title":"Growth trajectories of HIV exposed and HIV unexposed infants. A prospective study in Gweru, Zimbabwe","volume":"8","author":"Mabaya","year":"2021","journal-title":"Glob Pediatr Health"},{"key":"2025110820454196200_fmaf043-B5","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12889-021-12476-z","article-title":"Growth patterns of infants with in-utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambia","volume":"22","author":"Nyemba","year":"2022","journal-title":"BMC Public Health"},{"key":"2025110820454196200_fmaf043-B6","doi-asserted-by":"crossref","first-page":"157","DOI":"10.3389\/fped.2018.00157","article-title":"Surviving and thriving\u2014shifting the public health response to HIV-exposed uninfected children: report of the 3rd HIV-exposed uninfected child workshop","volume":"6","author":"Slogrove","year":"2018","journal-title":"Front Pediatr"},{"key":"2025110820454196200_fmaf043-B7","doi-asserted-by":"crossref","first-page":"e0227839","DOI":"10.1371\/journal.pone.0227839","article-title":"Impact of early-onset persistent stunting on cognitive development at 5 years of age: results from a multi-country cohort study","volume":"15","author":"Alam","year":"2020","journal-title":"PLoS One"},{"key":"2025110820454196200_fmaf043-B8","doi-asserted-by":"crossref","first-page":"101320","DOI":"10.1016\/j.eclinm.2022.101320","article-title":"Economic costs of childhood stunting to the private sector in low- and middle-income countries","volume":"45","author":"Akseer","year":"2022","journal-title":"EClinicalMedicine"},{"key":"2025110820454196200_fmaf043-B9","doi-asserted-by":"crossref","first-page":"e26159","DOI":"10.1002\/jia2.26159","article-title":"Neurodevelopment among children exposed to HIV and uninfected in sub-Saharan Africa","volume":"26","author":"Bulterys","year":"2023","journal-title":"J Int AIDS Soc"},{"key":"2025110820454196200_fmaf043-B10","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1097\/QAD.0000000000003124","article-title":"Higher prevalence of stunting and poor growth outcomes in HIV-exposed uninfected than HIV-unexposed infants in Kenya","volume":"36","author":"Neary","year":"2022","journal-title":"AIDS"},{"key":"2025110820454196200_fmaf043-B11","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/QAD.0000000000002405","article-title":"Decreased growth among antiretroviral drug and HIV exposed uninfected versus unexposed children in Malawi and Uganda","volume":"34","author":"Aizire","year":"2020","journal-title":"AIDS"},{"key":"2025110820454196200_fmaf043-B12","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/S2352-4642(19)30007-0","article-title":"Growth trajectories of breastfed HIV-exposed uninfected and HIV-unexposed children under conditions of universal maternal antiretroviral therapy: a prospective study","volume":"3","author":"Le Roux","year":"2019","journal-title":"Lancet Child Adolesc Health"},{"key":"2025110820454196200_fmaf043-B13","doi-asserted-by":"crossref","first-page":"2333794X19854964","DOI":"10.1177\/2333794X19854964","article-title":"Growth of HIV-exposed infants in southwest China: a comparative study","volume":"6","author":"Chen","year":"2019","journal-title":"Glob Pediatr Health"},{"key":"2025110820454196200_fmaf043-B14","doi-asserted-by":"crossref","first-page":"e0256443","DOI":"10.1371\/journal.pone.0256443","article-title":"Comparing growth velocity of HIV exposed and non-exposed infants: an observational study of infants enrolled in a randomized control trial in Zambia","volume":"16","author":"Chilyabanyama","year":"2021","journal-title":"PLoS One"},{"key":"2025110820454196200_fmaf043-B15","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/s12887-017-0828-6","article-title":"Growth of HIV-exposed uninfected, compared with HIV-unexposed, Zambian children: a longitudinal analysis from infancy to school 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