Growth and neurodevelopmental trajectories among HIV-exposed uninfected children

hiv暴露与神经发育之间的异质性可归因于研究设计的差异或未测量的混杂因素。值得注意的是，HEU儿童可能会经历其他生长和神经发育迟缓的风险因素，如贫困、营养不良或社会经济劣势（1,5）。因此，为了适当地调整潜在的混杂因素，在前瞻性队列中研究HEU儿童的生长和神经发育至关重要，这些队列招募早期怀孕的参与者，进行频繁的随访，并收集可靠的人体测量学、生物医学和社会经济数据。目的：本博士项目将研究HEU和HUU儿童生长迟缓和神经发育受损的危险因素。为此，该项目有三个主要目标（图1）：通过系统评价和荟萃分析，评估暴露于艾滋病毒的未感染儿童与未暴露于艾滋病毒的未感染儿童在24月龄时生长和神经发育的差异。评估南非艾滋病毒暴露的未感染儿童和未暴露的未感染儿童24月龄神经发育的决定因素。确定抗逆转录病毒治疗方案类型与南非艾滋病毒暴露的未感染儿童围产期结局之间的关系。

The reported heterogeneity in the association between HIV-exposure and neurodevelopment could be attributed to differences in study design or unmeasured confounding. Notably, HEU children are likely to experience other risk factors for delayed growth and neurodevelopment, such as poverty, undernutrition or socioeconomic disadvantage (1,5). To appropriately adjust for potential confounding factors, it is therefore central to study growth and neurodevelopment among HEU children in prospective cohorts that recruit participants during early pregnancy, conduct frequent follow-up, and collect robust anthropometric, biomedical, and socioeconomic data.AimsThis DPhil project will investigate risk factors for delayed growth and impaired neurodevelopment among HEU and HUU children. To this end, the project has three principal aims (Figure 1):1. Assess differences in growth and neurodevelopment at 24 months age among HIV-exposed uninfected children compared to HIV-unexposed uninfected children through a systematic review and meta-analysis.2. Assess determinants of neurodevelopment at 24 months age among HIV-exposed uninfected and HIV-unexposed uninfected children in South Africa.3. Determine the association between types of ART regimen and perinatal outcomes among HIV exposed uninfected children in South Africa.