Body composition of children born HIV-exposed uninfected in rural Zimbabwe
5 affiliations
- 1Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
- 2Blizard Institute, Queen Mary University of London, London, United Kingdom
- 3Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- 4Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- 5Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
Abstract
Background: Globally, 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. Methods: In 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. Results: CHEU 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. Conclusion: CHEU 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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BibTeX
@article{piper2026body,
title = {{Body composition of children born HIV-exposed uninfected in rural Zimbabwe}},
author = {Joe D. Piper and Robert Ntozini and Idah Mapurisa and Tsitsi Mashedze and Clever Mazhanga and Florence D. Majo and Bernard Chasekwa and Naume V. Tavengwa and Kim Michaelsen and Jean Humphrey and Jonathan Wells and Andrew J. Prendergast},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0319542},
url = {https://doi.org/10.1371/journal.pone.0319542},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Body composition of children born HIV-exposed uninfected in rural Zimbabwe
AU - Joe D. Piper
AU - Robert Ntozini
AU - Idah Mapurisa
AU - Tsitsi Mashedze
AU - Clever Mazhanga
AU - Florence D. Majo
AU - Bernard Chasekwa
AU - Naume V. Tavengwa
AU - Kim Michaelsen
AU - Jean Humphrey
AU - Jonathan Wells
AU - Andrew J. Prendergast
PY - 2026
DA - 2026/09/11
JO - PLOS One
DO - 10.1371/journal.pone.0319542
UR - https://doi.org/10.1371/journal.pone.0319542
AB - Background: Globally, 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. Methods: In 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. Results: CHEU 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. Conclusion: CHEU 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.
SN - 1932-6203
ER -