Growth Trajectories of 2 to 6-Year-Old Children Infected with or Exposed to HIV: A 9-Month Follow-Up

Background/Objectives: HIV infection is associated with growth faltering, including stunting, wasting, and malnutrition, particularly during early childhood. However, limited longitudinal evidence exists regarding growth trajectories in such vulnerable populations. This study examined the growth trajectories of South African children aged 2–6 years who were HIV-infected or exposed to HIV (HEU) over a nine-month period while comparing them with HIV-unexposed, uninfected (HU) children. Method: HIV-infected (n = 16; mean age, 4.63 years), HIV-exposed uninfected (HEU) (n = 11; mean age, 3.90 years), and HIV-unexposed uninfected (HU) (n = 11; mean age, 4.34 years) children participated in the study. Height, weight, upper-arm circumference, and skinfold thickness were obtained, while body mass index (BMI), stunting, and wasting indicators were calculated. Assessments were conducted at baseline and every 3 months over 9 months. Frequency distributions across groups were analysed against CDC growth percentiles using repeated-measures ANOVA with Bonferroni post hoc tests in Statistica for Windows to assess changes over time. Results: Linear growth vulnerability persisted among HIV-infected and HEU children despite improvements in weight-related indicators. Both HIV-infected and HEU children exhibited stunting (<−2 SD), while the HIV-infected group was underweight (<−2 SD) at baseline. HEU children showed weight gains but exhibited distinct growth patterns, indicating a continued risk of suboptimal growth outcomes compared with HU children. Conclusions: The observed growth trajectories indicate persistent linear growth vulnerability among HIV-infected and HEU children, despite improvements in weight-related indicators. Regular and early growth monitoring and timely and sustained nutritional support remain essential in paediatric HIV care, as improvements in weight do not necessarily translate into optimal linear growth among children affected by HIV.