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.
Children born HIV-exposed uninfected (CHEU) had significantly lower anthropometric measurements compared to HIV-unexposed children (CHU) at 2 years of age.
CHEU had a lower impedance index than CHU, reflecting reduced lean mass.
CHEU had lower skinfold thicknesses than CHU, indicating reduced subcutaneous fat.
CHEU had lower birthweight than CHU in early life.
Neither stunting nor birthweight explained the body composition differences observed between CHEU and CHU.
The authors suggest that the distinct pattern of reduced lean and fat mass in CHEU may contribute to their increased vulnerability to mortality, morbidity, and reduced neurodevelopment.
This research suggests that children who were exposed to HIV during pregnancy but were not themselves infected (called HIV-exposed uninfected children, or CHEU) have measurably different body composition at 2 years of age compared to children with no HIV exposure. Specifically, CHEU had less lean muscle mass and less body fat, as well as smaller overall body measurements including height, weight, arm circumference, and calf circumference. The study measured 223 children in rural Zimbabwe, of whom 36 were CHEU and 187 were unexposed. Importantly, the researchers tested whether these differences could simply be explained by the fact that CHEU tend to be shorter (stunted) or were born with lower birth weight — two well-known disadvantages for CHEU. However, neither stunting nor lower birthweight accounted for the body composition differences, meaning something else about HIV exposure during pregnancy appears to independently affect how children's bodies develop in terms of both muscle and fat tissue. This research matters because there are approximately 15 million CHEU children worldwide, and they are known to face higher risks of death, illness, and developmental problems compared to unexposed children. By identifying that CHEU have reduced lean and fat mass beyond what can be explained by their smaller size or birth weight, this study points to body composition as a potential underlying mechanism for their poorer health outcomes. Understanding these differences could help researchers and public health practitioners develop targeted interventions to improve the health and survival of this large and vulnerable group of children.
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Upload Your LabsPiper J, Ntozini R, Mapurisa I, Mashedze T, Mazhanga C, Majo F, et al.. (2026). Body composition of children born HIV-exposed uninfected in rural Zimbabwe.. PloS one. https://doi.org/10.1371/journal.pone.0319542