LAUSR

OBJECTIVE To determine immune-metabolic dysregulation in children born to women living with HIV. METHODS Longitudinal immune-metabolomic analyses of plasma of 32 pregnant women living with HIV (WLHIV) and 12 uninfected women and their children up to 1.5 years of age were performed. RESULTS Using liquid chromatography-mass spectrometry and a multiplex bead assay, 280 metabolites (57 amino acids, 116 positive lipids, 107 signaling lipids) and 24 immune mediators (e.g. cytokines) were quantified. cART exposure was categorized as cART initiation preconception (long), cART initiation post-conception up to 4 weeks before birth (medium) and cART initiation within 3 weeks of birth (short). Plasma metabolite profiles differed between HEU-children with long cART exposure compared to HIV-unexposed-children (HUU). Specifically, higher levels of methionine-sulfone, which is associated with oxidative stress, were detected in HEU-children with long cART exposure compared to HUU-children. High infant methionine-sulfone levels were reflected by high prenatal plasma levels in the mother. Increased methionine-sulfone levels in the children were associated with decreased growth, including both weight and length. CONCLUSION These findings based on longitudinal data demonstrate that dysregulation of metabolite networks associated with oxidative stress in children born to WLHIV is associated with restricted infant growth.