Body composition in HIV-infected children : relations with disease progression and survival

Malnutrition is common in HIV-infected children, but the body compartment that is most affected has been ill defined. Our objectives were to 1) compare the fat-free mass (FFM) of children with HIV infection with that of control children, 2) assess the contribution of FFM to body weight in HIV-infect...

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Bibliographic Details
Published in:	The American journal of clinical nutrition 1999-06, Vol.69 (6), p.1282-1286
Main Authors:	FONTANA, M, ZUIN, G, PLEBANI, A, BASTONI, K, VISCONTI, G, PRINCIPI, N
Format:	Article
Language:	eng
Subjects:	Acquired immune deficiency syndrome AIDS AIDS/HIV Analysis of Variance Anthropometry Biological and medical sciences Body Composition Child Children & youth Cross-Sectional Studies Disease Progression Electric Impedance Female HIV HIV Infections - classification HIV Infections - mortality HIV Infections - physiopathology HIV Infections - transmission Human immunodeficiency virus Human viral diseases Humans Infectious Disease Transmission, Vertical Infectious diseases Male Malnutrition Medical sciences Metabolic diseases Other nutritional diseases (malnutrition, nutritional and vitamin deficiencies...) Prognosis Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:	Malnutrition is common in HIV-infected children, but the body compartment that is most affected has been ill defined. Our objectives were to 1) compare the fat-free mass (FFM) of children with HIV infection with that of control children, 2) assess the contribution of FFM to body weight in HIV-infected children compared with that of control children, and 3) study the relations between body weight, FFM, and mortality. A cross-sectional study was performed in 86 HIV-infected and 113 uninfected children (mean ages: 6.9 and 7.7 y, respectively). FFM was estimated from single-frequency bioelectrical impedance analysis by using 3 different published equations; a further estimate was obtained from triceps-skinfold-thickness measurements. All 4 estimates of body composition showed that FFM in HIV-infected children was significantly less than in control children of similar age. However, FFM as a percentage of body weight was not significantly different between groups. In the whole group of infected children, an age-specific z score < -2 for weight and for FFM was significantly associated with an increased risk of death [relative risk (95% CI) = 11.4 (3.1, 41.0) and 5.1 (1.5, 18.2), respectively]; when only children with more severe disease were considered, only z score for weight was significantly associated with an increased risk [4.6 (1.4, 14.9)]. These findings suggest that no preferential catabolism of FFM occurs in HIV-infected children and that body weight for age is a better prognostic indicator than is FFM estimated by bioelectrical impedance analysis.
ISSN:	0002-9165 1938-3207