Abstract

With the success of chemoprophylaxis for the prevention of perinatal transmission of the human immunodeficiency virus (HIV), an increasing number of HIV-exposed but uninfected (HEU) children will have in utero and post-partum exposure to antiretroviral drugs and survive beyond infancy. The long term effect of antiretroviral drug exposure is however not fully understood. A few studies from developing countries have reported on growth, morbidity, mortality, nutrition, immunological profiles, neurodevelopment and behavioral disorders of HEU children. As the number of HEU children continues to increase worldwide, questions of clear public health importance need to be addressed: Is the health status and survival of HEU children into adolescence influenced by exposure to HIV-1 and/or combination antiretroviral therapy (cART) in utero or during infancy? To what extent is the long term neurodevelopmental outcomes influenced by being born into an HIV affected household. The aim of this review is to describe current evidence on health outcomes of HEU children, from resource constrained settings, as they mature into adolescence. Systemic review of literature (MEDLINE, PUBMED, Cochrane library, Google scholar,) published in 1999 to December 2015 was conducted. At school-aged HEU children had lower values of most anthropometric parameters than HIV unexposed uninfected (HUU) children at birth, all significant differences diminished after controlling for socioeconomic variables. Lower socioeconomic status is an independent risk factor for neurocognitive impairment and malnutrition in resource constrained settings. More research is required to assist healthcare workers in managing HEU children since this is an emerging problem.

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