Haemoglobin levels and growth of South African infants aged 6–12 months exposed to maternal HIV infection

Abstract

Introduction Anaemia is a significant public health concern in women of reproductive age and children under five years old, particularly in high HIV-prevalent settings.Objective This study analysed differences in haemoglobin levels and growth between human immunodeficiency virus (HIV)-exposed-but-uninfected (HEU) and HIV-unexposed-uninfected (HUU) infants, and further determined correlations between haemoglobin levels and growth at 6, 9, and 12 months in the Siyakhula study.Results At 6, 9, and 12 months postpartum, the maternal mean haemoglobin levels and anaemia status differed significantly by HIV status (p < 0.05), while HEU and HUU infants showed similar mean haemoglobin levels and anaemia status. Anaemia was prevalent in HEU infants at 6 (27%), 9 (33%), and 12 (30%) months. The HEU infants had lower weight-for-age Z-scores (WAZ) and mid-upper-arm circumference-for-age Z-scores (MUACZ) than HUU infants at 6, 9, and 12 months (p < 0.05). At 12 months, HEU infants had lower mean weight-for-length Z-scores (WLZ) than the HUU infants (-0.2 ± 1.2 vs. 0.2 ± 1.2; p = 0.020). The HEU infants had a higher prevalence of stunting at 6 months (16% vs. 8%; p = 0.044), and less breastfeeding at 9 (36% vs. 57%; p = 0.013) and 12 (25% vs. 48%; p = 0.005) months than the HUU infants. In HEU infants, positive correlations were found between infants’ haemoglobin levels and WAZ (p = 0.039), LAZ (p = 0.007), and MUACZ (p = 0.039) at 9 months, and with WAZ (p = 0.018) and WLZ (p = 0.017) at 12 months, while negative correlations were found between infant haemoglobin levels and any breastfeeding practices at 6, 9, and 12 months (p = 0.026; p < 0.001; p = 0.036).Conclusion Maternal HIV infection can negatively impact infant growth, and anaemia remains a public health concern in South Africa.