# P-495. Assessing Growth and Neurodevelopment in HIV-Exposed Uninfected Children: A Ghanaian Case-Control Study

## TL;DR

This study in Ghana found that HIV-exposed uninfected children have similar growth and development to HIV-unexposed children, with socioeconomic factors being more important for outcomes.

## Contribution

The study provides new evidence on the long-term growth and neurodevelopmental outcomes of HIV-exposed uninfected children in a resource-limited setting.

## Key findings

- HEU children showed no significant differences in growth or neurodevelopment compared to HUU children.
- Socioeconomic factors, such as caregiver education and income, were more strongly associated with child outcomes than HIV exposure.
- Low birth weight and prematurity were not linked to neurodevelopmental delays in either group.

## Abstract

The growing population of HIV-exposed uninfected (HEU) children due to effective PMTCT efforts necessitates understanding their long-term outcomes. This study compared the growth and neurodevelopment of HEU children to their HIV-unexposed, uninfected (HUU) peers in Ghana.Table ISocio-demographic and Clinical Characteristics of HEU and HUU ChildrenTable IIDistribution of HEU and HUU by Anthropometric Measurements

Socio-demographic and Clinical Characteristics of HEU and HUU Children

Distribution of HEU and HUU by Anthropometric Measurements

A hospital-based case-control study was conducted at 37 Military Hospital, Accra, from December 2021 to August 2022. We enrolled 315 children aged 2–5 years—150 HEU and 165 HUU. Maternal/carer sociodemographic data were collected via structured interviews. Nutritional status was assessed through anthropometry, and neurodevelopment was measured using the Malawi Developmental Assessment Tool (MDAT). Bivariate analysis and multivariate logistic regression identified factors associated with adverse outcomes.Table IIIEducational and Economic Characteristics of Caregivers of HEU and HUU ChildrenTable IV:Distribution of HEU and HUU children by Neurodevelopmental Profiles

Educational and Economic Characteristics of Caregivers of HEU and HUU Children

Distribution of HEU and HUU children by Neurodevelopmental Profiles

Normal weight-for-age was observed in 91.7% of HEU and 95.8% of HUU children. There were no significant differences in stunting between HEU and HUU children (23.5% vs. 23.0%, p=0.91). Neurodevelopmental assessments revealed no significant differences in gross motor, fine motor, language, or social domains. However, HEU carers had significantly lower education and income levels (p< 0.001). Low birth weight and prematurity were not associated with neurodevelopmental delays, irrespective of HIV exposure.

HEU children did not show inferior nutritional or neurodevelopmental outcomes compared to HUU peers. Socioeconomic factors were more predictive of adverse outcomes. These findings highlight the need for integrated early childhood support systems addressing broader determinants of health beyond HIV exposure. In addition, strengthening community-based support systems and policies that empower women through education and employment could further enhance child health outcomes in resource-limited settings.

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