BACKGROUND: Exposures to HIV and antiretroviral therapy in utero may have adverse effects on infant growth. We aimed to compare anthropometric outcomes of HIV exposed uninfected (HEU) children born in Denmark aged 0-5 years to children not exposed to HIV.

METHODS: In a nationwide register-based study we included all singleton HEU children born in Denmark, 2000-2016. HEU children were individually matched by child sex, parity and maternal country of birth to five singleton controls born to HIV uninfected mothers. Weight-for-age (WAZ), Length-for-age (LAZ) and Weight-for-Length (WLZ)/BMI-for-age (BMI) z-scores were generated according to the WHO standards and the Fenton growth chart for premature infants. Differences in WAZ, LAZ and BMI z-scores were analyzed using linear mixed models, both univariate and adjusted for social and maternal factors.

RESULTS: In total, 485 HEU children and 2.495 controls were included. Compared to controls, HEU children were smaller at birth with an adjusted difference in mean WAZ and LAZ scores of -0.29 (95%CI -0.46:-0.12: p=<0.001) and -0.51 (95%CI -0.71:-0.31: p=<0.001), respectively. Over time, there was a trend towards increasing WAZ and LAZ in HEU children, and there was no significant difference in adjusted WAZ z-scores after age 14 days (-0.13 (95% CI -0.27:0.01: p=0.07) and LAZ z-scores after age 6 months (-0.15 (95%CI -0.32:0.02: p=0.08).

CONCLUSION: Compared to a matched control group, HEU children were smaller at birth, but this difference decreased with time and is not considered to have a negative impact on the health and well-being of HEU children during early childhood.