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Malabsorption of different lactose loads in children with human immunodeficiency virus infection
Insights
Human immunodeficiency virus (HIV) infection increases lactose malabsorption in children. Lower lactose loads are more sensitive for detecting malabsorption, aiding nutritional management in infected children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nutritional Science
Background:
- Human immunodeficiency virus (HIV) infection can impact gastrointestinal function.
- Lactose malabsorption is a common issue, but its prevalence in HIV-infected children requires further investigation.
Purpose of the Study:
- To evaluate lactose malabsorption in children with HIV using the hydrogen breath test.
- To compare malabsorption prevalence across different lactose loads and disease stages (P1, P2).
Main Methods:
- Hydrogen breath test administered to 30 HIV-infected children and 54 noninfected children.
- Testing involved varying lactose loads (2 g/kg, 1 g/kg, 0.5 g/kg).
- Children classified as P1 or P2 based on Centers for Disease Control staging.
Main Results:
- Lactose malabsorption was higher in HIV-infected children (P2: 75%, P1: 67%) compared to noninfected children (46%) at a 2 g/kg load.
- Lower lactose loads (1 g/kg, 0.5 g/kg) revealed significantly higher malabsorption rates in P2 children.
- HIV-infected children with malabsorption were younger than noninfected counterparts.
Conclusions:
- HIV infection is associated with increased lactose malabsorption in children.
- Lower lactose loads are more effective in identifying malabsorption in this population.
- Findings support improved dietary management strategies for HIV-infected children with lactose intolerance.
Abstract:
Thirty children infected with human immunodeficiency virus (HIV) (18 P1 and 12 P2, according to the classification system of the Centers for Disease Control) and 54 noninfected children were evaluated for lactose malabsorption with use of the hydrogen breath test after different lactose loads. Lactose malabsorption after load of 2 g/kg occurred in 75% of P2, 67% of P1, and in 46% of noninfected children. With a lower lactose load (1 g/kg), the prevalence of malabsorption was significantly higher among P2 children than P1 and noninfected cases. A similar figure was obtained after the lowest load (0.5 g/kg). Infected children with lactose malabsorption were significantly younger than noninfected malabsorbers (mean age +/- SD; 50.3 +/- 22 vs. 63.5 +/- 20.9 months) when the load of 2 g/kg was used. The use of lower lactose loads seems to be helpful in finding the dose that can be tolerated. This finding could have nutritional importance and could lead to better dietary management.