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Fatty acid composition of plasma lipids in HIV-infected children. Comparison with seroreverters
C Agostoni1, E Riva, S Esposito
1Pediatric Department V, University of Milan, Italy. agostoc@tin.it
Insights
Children with human immunodeficiency virus (HIV) show impaired polyunsaturated fatty acid (PUFA) status, specifically lower linoleic acid (LA) levels. This deficiency correlates with higher viral load and lower CD4+ counts in HIV-positive children.
Area of Science:
- Pediatric Nutrition
- Virology
- Biochemistry
Background:
- Children with human immunodeficiency virus (HIV) are susceptible to nutritional deficiencies.
- Impaired polyunsaturated fatty acid (PUFA) status is a concern in pediatric HIV infection.
- Antiretroviral therapy may influence nutritional status in children with HIV.
Purpose of the Study:
- To compare plasma lipid PUFA composition in well-growing HIV-infected children versus HIV-seroreverter children.
- To investigate the relationship between PUFA status, viral load, and CD4+ cell counts in pediatric HIV.
- To identify specific PUFA alterations in children with HIV.
Main Methods:
- Comparison of plasma lipid classes (total lipids, phospholipids, cholesteryl esters, triglycerides) for fatty acid composition.
- Analysis of 18 HIV-infected children and 18 age-matched HIV-seroreverter children.
- Assessment of growth parameters, demographics, and dietary intake.
Main Results:
- Plasma fatty acid content was similar between groups, but HIV-positive children had lower linoleic acid (LA) levels across lipid fractions.
- Elevated 20:3n-9 and 20:5n-3 levels were observed in phospholipids (PL) and cholesteryl esters (CE) of HIV-infected children.
- The plasma PL triene/tetraene ratio, indicating relative LA deficiency, positively correlated with viral load and negatively with CD4+ lymphocyte count.
Conclusions:
- HIV-seropositive children exhibit a lipid fatty acid profile indicative of relative linoleic acid deficiency.
- Increased turnover of PUFA series is suggested in children with HIV.
- PUFA status, particularly LA, is linked to disease activity (viral load and CD4+ count) in pediatric HIV.
Abstract:
Children infected with the type-1 human immunodeficiency virus (HIV) are at risk of nutritional deficiencies leading to an impaired polyunsaturated fatty acid (PUFA) status. The aim of the present study was to compare the PUFA composition of plasma lipid classes (total lipids, phospholipids (PL), cholesteryl esters (CE) and triglycerides) in well-growing HIV-infected children with an age-matched group of HIV-seroreverter children born to infected mothers. Eighteen HIV children, of both sexes, mean age 4.6 y, most of whom under combined antiretroviral regimen, were compared with 18 seroreverters, mean age 5.4 y, comparable for demographic, anthropometric and dietary characteristics. All children had adequate growth parameters (weight and height > 3rd percentile). The plasma fatty acid content was similar in the two groups. HIV seropositive subjects showed lower linoleic acid (LA) levels in all the plasma lipid fractions, with higher 20:3n-9 and 20:5n-3 levels in PL and CE. The plasma PL triene/tetraene ratio (marker of relative LA deficiency) related positively to the viral load and negatively to the blood CD4+ lymphocyte count. Compared to age-matched seroreverter subjects, HIV-seropositive children show a lipid fatty acid status suggestive of relative LA deficiency and increased turnover of the PUFA series.