Growth in Children Affected by HIV

Children exposed to HIV in utero are at risk of adverse growth outcomes, even if they do not acquire HIV perinatally. Some growth impacts begin before birth, with children exposed to HIV being more likely to be born preterm and small for gestational age, as well as with low birthweight. Children born with HIV (CHIV) exhibit more growth differences than children exposed to HIV in utero but born uninfected (CHEU); although, early treatment with antiretroviral therapy significantly improves their growth outcomes. CHEU are also vulnerable to poor growth postnatally. The causes are multifaceted and include increased susceptibility to infection and socioeconomic vulnerabilities. Pediatricians must be aware of the unique growth vulnerabilities of CHIV and CHEU, so they can carefully follow growth while assessing potential drivers of growth disparities for each child to help ensure that they achieve their full growth potential.