Dietary Intake is an Important Predictor of Nutritional Status in HIV-Infected Children. • 497

Miller, Tracie L.; Evans, Sylvia; Vasquez, Isabel de los Angeles López; Orav, E. John

doi:10.1203/00006450-199704001-00517

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“…In HIV-1-infected children, preliminary evidence suggests that dietary intakes are adequate because the majority of these children meet or exceed the recommended daily allowance (RDA) for calories and macronutrients. 6,7 Some evidence suggests that dietary intakes that are much higher than the RDA can increase the weight of HIV-1-infected children. 7 Energy metabolism is less well-defined, but some studies suggest that resting energy expenditure in infected children is slightly higher than predicted, 8 which is also the case in adults with HIV-1 infection.…”

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confidence: 99%

“…6,7 Some evidence suggests that dietary intakes that are much higher than the RDA can increase the weight of HIV-1-infected children. 7 Energy metabolism is less well-defined, but some studies suggest that resting energy expenditure in infected children is slightly higher than predicted, 8 which is also the case in adults with HIV-1 infection. 9,10 Children with HIV-1 infection are also more likely than noninfected children to have problems absorbing nutrients, which can impair growth.…”

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confidence: 99%

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Maternal and Infant Factors Associated With Failure to Thrive in Children With Vertically Transmitted Human Immunodeficiency Virus-1 Infection: The Prospective, P2C2 Human Immunodeficiency Virus Multicenter Study

et al. 2001

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Objective-Many children with human immunodeficiency virus-1 (HIV-1) have chronic problems with growth and nutrition, yet limited information is available to identify infected children at high risk for growth abnormalities. Using data from the prospective, multicenter P 2 C 2 HIV study, we evaluated the relationships between maternal and infant clinical and laboratory factors and impaired growth in this cohort.Methods-Children of HIV-1-infected women were enrolled prenatally or within the first 28 days of life. Failure to thrive (FTT) was defined as an age-and sex-adjusted weight z score ≤−2.0 SD. Maternal baseline covariates included age, race, illicit drug use, zidovudine use, CD4 + T-cell count, and smoking. Infant baseline predictors included sex, race, CD4 + T-cell count, Centers for Disease Control stage, HIV-1 RNA, antiretroviral therapy, pneumonia, heart rate, cytomegalovirus, and Epstein-Barr virus infection status.Results-The study cohort included 92 HIV-1-infected and 439 uninfected children. Infected children had a lower mean gestational age, but birth weights, lengths, and head circumferences in the 2 groups were similar. Mothers of growth-delayed infants were more likely to have smoked Copyright © 2001 by the American Academy of Pediatrics. Reprint requests to (T.L.M.) Division of Pediatric Gastroenterology and Nutrition, Box 667, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642. tracie_miller@urmc.rochester.edu. National Heart, Lung, and Blood Institute, Bethesda, MD The institutions and investigators participating in this study are listed in the "Appendix." HHS Public Access Author manuscriptPediatrics. Author manuscript; available in PMC 2015 April 03. Published in final edited form as:Pediatrics. 2001 December ; 108(6): 1287-1296. Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript tobacco and used illicit drugs during pregnancy. In repeated-measures analyses of weight and length or height z scores, the means of the HIV-1-infected group were significantly lower at 6 months of age (P < .001) and remained lower throughout the first 5 years of life. Conclusion-Clinical and laboratory factors associated with FTT among HIV-1-infected children include history of pneumonia, maternal illicit drug use during pregnancy, lower infant CD4 + T-cell count, exposure to antiretroviral therapy by 3 months of age (non-protease inhibitor), and HIV-1 RNA viral load. Keywordshuman immunodeficiency virus; children; failure to thrive; growth; malnutrition Many children with human immunodeficiency virus-1 (HIV-1) infection have chronic problems with linear growth and weight gain. 1-5 A variety of disturbed growth patterns have been described, ranging from symmetric delays in weight and length or height to severe wasting with normal length or height. The differences in growth patterns probably result from differences in disease manifestations in HIV-1-infected children. In developed countries, both weight and length or height decline in infected children as early as...

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Maternal and Infant Factors Associated With Failure to Thrive in Children With Vertically Transmitted Human Immunodeficiency Virus-1 Infection: The Prospective, P2C2 Human Immunodeficiency Virus Multicenter Study

et al. 2001

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“…We have collected dietary records of children who are HIV-positive, children with AIDS and controls (Miller et al 1997a). In this study of over 700 food records, we found that total energy intake is similar across groups, as were the intakes of the protein, carbohydrate and fat.…”

Section: Dietary Intakementioning

confidence: 94%

“…Dietary intake over time was stable in all groups. We determined the influence of the dietary intake on weight across quartiles and found that diets of 115 % of the RDA had the greatest effect and influence on weight Z-score (Miller et al 1997a). Of the cohort, 25 % consumed 160 % of the RDA or more.…”

Section: Dietary Intakementioning

confidence: 99%

“…We have been prospectively evaluating growth and nutritional indices over the last several years at Children's Hospital, Boston, MA, USA and the University of Rochester Medical Center, MN, USA (Miller et al 1997a). An evaluation of growth and body composition of seventy-nine HIV-infected children, twenty-one children with AIDS and 113 controls, before protease-inhibitor therapy, showed that weight Z-scores of HIV-infected children and children with AIDS at first evaluation were not significantly different, although there were significant differences between both the HIV-positive patients and patients with AIDS and the control patients (P < 0·05; Table 1).…”

Section: Growth and Body Composition Of Human Immunodeficiency Virus-mentioning

confidence: 99%

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Nutrition in paediatric human immunodeficiency virus infection

Miller

2000

Proc. Nutr. Soc.

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The nutritional condition of children with human immunodeficiency virus (HIV) infection continues to be a problem both in developed and developing countries. HIV-infected children grow below normal standards in both height and weight when compared with HIV-exposed non-infected children. These patterns persist over time. It is possible that acute infectious episodes and increased HIV viral burden contribute to decrements in all growth variables. Potential aetiologies for abnormal growth include inadequate dietary intake, gastrointestinal malabsorption, increased energy utilization and psycho-social problems. It is likely that all these factors contribute to the growth problems of these children to some extent. With the development of protease inhibitor anti-retroviral therapy and highly-active anti-retroviral treatment regimens, children with HIV infection in developed countries are living longer with a chronic illness. New nutritional problems have arisen with the development of the fat redistribution syndrome or lipodystrophy. Emerging problems are now being recognized, with the development of insulin resistance and truncal obesity which may potentially lead to premature cardiovascular disease.

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Uso de inibidores de protease e alterações do lipidograma e do estado nutricional de crianças e adolescentes infectados pelo vírus da imunodeficiência humana (HIV-1)

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Dietary Intake is an Important Predictor of Nutritional Status in HIV-Infected Children. • 497

Cited by 5 publications

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Maternal and Infant Factors Associated With Failure to Thrive in Children With Vertically Transmitted Human Immunodeficiency Virus-1 Infection: The Prospective, P2C2 Human Immunodeficiency Virus Multicenter Study

Maternal and Infant Factors Associated With Failure to Thrive in Children With Vertically Transmitted Human Immunodeficiency Virus-1 Infection: The Prospective, P2C2 Human Immunodeficiency Virus Multicenter Study

Nutrition in paediatric human immunodeficiency virus infection

Uso de inibidores de protease e alterações do lipidograma e do estado nutricional de crianças e adolescentes infectados pelo vírus da imunodeficiência humana (HIV-1)

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