During the past year, data regarding the micronutrient status of HIV- infected children were presented at the annual meeting of the Federation of American Societies for Experimental Biology in Washington, DC. In addition, two manuscripts and two abstracts are currently under review. Based upon our analyses to date, we conclude the following: 1. Decreased serum or plasma protein or micronutrient levels were uncommon in this cohort of HIV+ children, and do not appear to play a major role in growth retardation. Routine monitoring of the proteins and micronutrients studied is unnessary in the absence of specific clinical indicators of deficiency. 2. Lean body mass was significantly reduced in HIV+ children with growth retardation compared to HIV-children, and fat mass was significantly reduced in HIV+ compared to HIV- children. The percentages of lean and fat mass were not significantly different between groups, suggesting that differences in lean and fat mass were proportional to differences in body size. Consistent with the reduction in lean mass, mean resting energy expenditure (REE) was significantly lower in HIV+ children with growth retardation compared to HIV-children. Mean REE per kilogram body weight or lean mass was higher in the two HIV+ groups, although not statistically significant. Mean energy intake was not significantly different between groups. This data suggests that increased REE or inadequate energy intake may play a role in growth retardation of this population. 3. Although not statistically significant, the mean rates of protein turnover, synthesis, and catabolism were higher in HIV+ children with growth retardation compared to HIV+ children with normal growth and HIV- children, and higher in HIV+ than HIV-children. These results suggest a trend towards increased protein turnover in HIV+ children, which may play a role in growth retardation.
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