Growth and micronutrient disturbances in stable, HIV-infected children in Cape Town.
This prospective study of 60 stable, HIV-infected children in an economically deprived setting was designed to document anthropometric and micronutrient disturbances. Investigations included CD4+ counts, anthropometry and plasma levels of albumin, transthyretin, retinol-binding protein (RBP), vitamins A, B6, E and B12, and folate, zinc and copper. The median age was 25 months. Thirty-two per cent had mild, 48% moderate and 20% severe clinical features, and 80% were moderately or severely immunosuppressed. Twenty-eight per cent had a weight Z-score <-2.0 and 58% a height Z-score <-2.0. Many children had micronutrient deficiencies: albumin (70%), transthyretin (100%), RBP (85%), vitamins A (80%), B6 (37%), E (37%) and B12 (5%), zinc (20%) and copper (25%). Sixty-two per cent had two or more trace element or vitamin deficiencies. There was a weak association between micronutrient status and disease status. Micronutrient concentrations did not correlate with chronological age, height-for-age or weight-for-age. CRP was elevated in 53% but did not correlate with any of the micronutrient concentrations. Micronutrient deficiencies were more common and micronutrient concentrations lower in children over 24 months of age.
Eley
Brian S
BS
Departments of Paediatrics & Child Health, University of Cape Town, South Africa. beley@ich.uct.ac.za
Sive
Alan A
AA
Abelse
Lisa
L
Kossew
Glynis
G
Cooper
Margaret
M
Hussey
Gregory D
GD
D000886:Anthropometry; D002097:C-Reactive Protein / Q000032:analysis; D018791:CD4 Lymphocyte Count; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000097:blood / Q000150:complications*; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D007223:Infant; D008297:Male; D018977:Micronutrients / Q000097:blood*; D011203:Poverty; D011446:Prospective Studies; D013019:South Africa
D018977:Micronutrients; D002097:C-Reactive Protein