CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

1023 Cardiometabolic Outcomes in HEU vs HU Children in a SA Birth Cohort: Influence of Maternal Lipids Calli Dogon 1 , Jennifer Pellowski 1 , Heather Zar 2 , Angela Bengtson 3 , Tiffany Burd 2 , Maresa Botha 2 , Lesley Workman 2 1 Brown University, Providence, RI, USA, 2 University of Cape Town, Cape Town, South Africa, 3 Emory University, Atlanta, GA, USA Background: HIV-Exposed Uninfected (HEU) children have worse cardiometabolic health outcomes, compared to HIV-Unexposed uninfected (HU) children, but the effect of maternal cardiometabolic health in pregnancy on child outcomes is not clear. Our study investigated the impact of maternal gestational lipid biomarkers on child cardiometabolic health indicators in a birth cohort of South African HEU and HU children, the Drakenstein Child Health Study (DCHS). Methods: The DCHS is a longitudinal birth cohort in a peri-urban area of South Africa (N=1143 live born infants). Our study randomly sampled 260 mother child pairs from DCHS (N= 100 HEU & N= 160 HU). We used multivariable linear regression to assess associations between maternal lipid biomarkers from 2nd trimester of pregnancy (20-28 weeks’ gestation) with child cardiometabolic indicators at 5-8 years of age and explored potential effect modification by HEU status in stratified analyses. Child cardiometabolic indicators included lipid and glucose metabolism, blood pressure, and body composition. Results: Associations were found between maternal total cholesterol (TC) and child TC and low-density lipoprotein (LDL) [TC; mean difference [MD] 0.19, 95% CI 0.09, 0.30] & [LDL; MD 0.21, 95% CI 0.12, 0.31]. When stratified by HIV exposure status, the relationship between maternal TC and child TC was stronger in HEU children than in HU children [HEU; MD 0.29, 95% CI 0.13, 0.45 vs HU; MD 0.13, 95% CI -0.01, 0.27]. The relationship between maternal TC and child LDL was also observed to be stronger in the HEU child [HEU; MD 0.26, 95% CI 0.13, 0.40 vs HU MD 0.18, 95% CI 0.05, 0.30]. Maternal LDL had similar associations with child TC and LDL (table 1). Maternal high-density lipoprotein (HDL) influenced the child HDL levels [MD 0.13, 95% CI 0.03, 0.23]; when stratified, this association was only demonstrated in the HU child [HU; MD 0.21, 95% CI 0.08, 0.34 vs HEU; MD 0.02, 95% CI -0.15, 0.19]. No significant associations were found between maternal lipids and child HbA1c, insulin resistance, systolic or diastolic blood pressure or body composition. Conclusions: In a birth cohort of South African HEU and HU children, maternal gestational lipid profiles influenced child lipid metabolism, and this relationship may differ based on in-utero HIV exposure status. These findings suggest optimizing maternal lipid profiles during pregnancy may improve child cardiometabolic indicators, particularly in the context of HIV exposure and should be evaluated in larger cohorts.

Bifidobacterium populations may be of particular importance in influencing growth among CHEU.

The figure, table, or graphic for this abstract has been removed. 1022 Insulin-Like Growth Factors and Stunting in African Infants Exposed to HIV and Uninfected Brenda C. Kakayi 1 , Patricia DeMarrais 2 , Kristin Baltrusaitis 2 , Lynda Stranix Chibanda 3 , Clemensia Nakabiito 1 , Vivian Rexroad 4 , Maxensia Owor 1 , Sufia Dadabhai 4 , Dhayendre Moodley 5 , Friday Saidi 6 , Avy Violari 7 , Gerhard Theron 8 , Mary G. Fowler 9 , Takara L. Stanley 10 , for the IMPAACT P1084s Protocol Team 1 Makerere University–Johns Hopkins University Research Collaboration, Kampala, Uganda, 2 Harvard TH Chan School of Public Health, Boston, MA, USA, 3 University of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe, 4 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 5 University of KwaZulu-Natal, Durban, South Africa, 6 University of North Carolina Project– Malawi, Lilongwe, Malawi, 7 University of Witwatersrand, Johannesburg, South Africa, 8 Stellenbosch University, Cape Town, South Africa, 9 The Johns Hopkins University School of Medicine, Baltimore, MD, USA, 10 Massachusetts General Hospital, Boston, MA, USA Background: The biological mechanisms related to increased risk of stunting in infants/children who are HIV-exposed and uninfected (CHEU) are not fully clear. We assessed whether insulin-like growth factors (IGFs), which are associated with infant growth, are determinants for stunting observed among CHEU. Methods: A random sample of 213 out of 268 infants from the antepartum part of the IMPAACT P1084s substudy with at least one serum sample collected at the birth visit, week 26 or week 74 visits in Uganda, South Africa and Malawi was selected. Stored serum was analysed for IGF-1, IGF Binding Protein (IGFBP)-1 and IGFBP-3 by Quest Diagnostics using in-house assays validated in accordance with CLIA regulations. IGF-1 was measured using liquid chromatography/ mass spectrometry, IGFBP-1 using radioimmunoassay and IGFBP-3 using immunoassay. Risk ratios (RRs) for stunting (length-for-age z (LAZ) -score<-2 standard deviations (SDs)) at birth, weeks 26 and 74 were estimated using log-binomial regression models with log-transformed growth factors at birth as predictors. Cross-sectional associations between LAZ-scores and log transformed growth factors at birth, weeks 26 and 74 were evaluated using adjusted linear regression models. Results: 213 infant participants (47% male) were included. The median (Q1, Q3) weight within 5 days of birth was 2.9 kg (2.6, 3.2) and length was 48 cm (46, 50), representing a median LAZ-score of -1 SDs (-2, 0). Although higher IGF-1 at birth was significantly associated with reduced risk of stunting at week 26 (RR: 0.4 per log 10 increase; 95% confidence interval (CI): 0.19, 0.86), IGFBP-1 or IGFBP-3 at birth were not associated with future stunting (Table 1, Analysis 1). Table 1, Analysis 2 shows that, at 74 weeks, LAZ-scores increased per log 10 increase in IGF-1 (1.60; 95% CI: 1.15, 2.04), decreased per log 10 increase in IGFBP-1 (-0.62; 95% CI: -1.21, -0.02), and increased per log 10 increase in IGFBP-3 (2.08; 95% CI: 1.26, 2.91). Similar observations were made at week 26. Conclusions: Growth factor levels were significantly associated with LAZ scores at 26 weeks and 74 weeks of age. However, only modest associations between growth factor levels at birth and future stunting were shown in this population. Therefore, variations in IGF levels may not be the main determinant for stunting in CHEU. Other mechanisms independent of the growth hormone/ IGF axis should be explored.

Poster Abstracts

1024 Obesity and Metabolic Comorbidities in Young Adults With Perinatal HIV Exposure Without Infection Nikhita Chahal, Allison K. Arpante, Julia E. Johnson, Camille A. Dash, Mollie W. Ockene, Isabel Zheng, Autumn Boutin, Hang Lee, Kathleen Corey, Takara L. Stanley, Steven Grinspoon, Lindsay T. Fourman Massachusetts General Hospital, Boston, MA, USA Background: The global scale-up of prenatal antiretroviral therapy (ART) has reduced the vertical transmission of HIV to <1%. In this context, a growing population of individuals with perinatal HIV exposure without infection (PHEU) has emerged, which now exceeds 20 million people worldwide. While growing evidence indicates that infants and children with PHEU are at increased risk of metabolic abnormalities, the long-term sequelae of in utero HIV/ART exposure into adulthood are largely unknown.

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