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Faecal calprotectin in HIV-infected, HAART-naïve Ugandan children
E Hestvik1, E Olafsdottir, T Tylleskar
1Centre for International Health, University of Bergen, Bergen, Norway. elin.hestvik@cih.uib.no
Insights
Faecal calprotectin (FC) levels are elevated in HIV-infected Ugandan children, indicating gut inflammation, especially in those with advanced disease. FC concentrations decrease with age but remain higher than reference values in children over 4 years old.
Area of Science:
- Pediatric infectious diseases
- Gastroenterology
- Immunology
Background:
- Calprotectin is a biomarker for gastrointestinal inflammation.
- Reference values for fecal calprotectin (FC) exist for children over 4 years old.
- Human immunodeficiency virus (HIV) infection can impact gastrointestinal health.
Purpose of the Study:
- To determine fecal calprotectin (FC) concentrations in HIV-infected, antiretroviral therapy-naïve Ugandan children.
- To compare FC levels in this cohort with established reference values.
- To explore the relationship between FC levels, age, CD4 cell percentage, and diarrhea.
Main Methods:
- A hospital-based survey of 193 HIV-infected children (ages 0-12 years) in Uganda.
- Measurement of fecal calprotectin (FC) concentrations.
- Collection of sociodemographic data, medical history, and CD4 cell percentages.
Main Results:
- Median FC concentrations decreased with increasing age, similar to healthy children.
- Median FC: 208 mg/kg (infants 0-1 yr), 171 mg/kg (toddlers 1-4 yr), 62 mg/kg (children 4-12 yr).
- Higher FC levels were observed in children with advanced HIV disease (low CD4 percentage) and those with diarrhea (in children >4 yrs).
Conclusions:
- HIV-infected children over 4 years old exhibited FC concentrations above the reference value, suggesting likely gut inflammation.
- Elevated FC levels were associated with more advanced HIV disease, irrespective of age.
- FC may serve as a valuable indicator of gut inflammation in pediatric HIV infection.
Objectives:
Calprotectin is a calcium- and zinc-binding protein and a marker in faeces of gastrointestinal inflammation. Reference values have been established in children older than 4 years. The aim of the present study was to determine the concentration of faecal calprotectin (FC) in human immunodeficiency virus (HIV)-infected, highly active antiretroviral therapy-naïve Ugandan children and compare it with the reference value.
Methods:
We tested 193 HIV-infected children ages 0 to 12 years in a hospital-based survey for FC. A standardised interview with sociodemographic information and medical history was used to assess risk factors. A cluster of differentiation 4 (CD4) cell percentage was prevalent in all of the children.
Results:
The median FC concentrations decreased with increasing age, as in healthy children. The median concentration was 208 mg/kg in infants 0 to 1 year, 171 mg/kg among toddlers 1 to 4 years, and 62 mg/kg for children 4 to 12 years. Children with advanced disease and a low CD4 cell percentage had significantly higher FC concentrations than those with a high CD4 cell percentage. Children older than 4 years with diarrhoea had significantly higher FC concentrations compared with those without diarrhoea.
Conclusions:
HIV-infected children older than 4 years had a median FC concentration above the reference value, and gut inflammation in the children with elevated values is likely. Children with more advanced disease had increased FC concentrations regardless of age.
