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Body composition in prepubertal children with human immunodeficiency virus type 1 infection
S M Arpadi1, M N Horlick, J Wang
1Department of Pediatrics, Columbia University, College of Physicians and Surgeons and School of Public Health, St Luke's-Roosevelt Hospital Center, New York, NY 10025, USA. smarpadi@pol.net
Insights
Human immunodeficiency virus (HIV) infection in children is associated with reduced fat-free mass (FFM) and body cell mass (BCM), particularly in those with growth failure (GF). This decrease in FFM and BCM, unlike fat mass, highlights a specific impact of HIV on body composition.
Area of Science:
- Pediatric Endocrinology
- Infectious Diseases
- Human Physiology
Background:
- Human immunodeficiency virus (HIV) infection can significantly impact child development and growth.
- Understanding body composition changes in HIV-infected children is crucial for managing their health.
- Growth failure (GF) is a common complication in pediatric HIV infection.
Purpose of the Study:
- To precisely characterize the body composition of HIV-infected children, with a focus on those experiencing growth failure (GF).
- To differentiate body composition profiles between HIV-infected children with and without GF, and healthy controls.
- To utilize laboratory-based methods for accurate body composition assessment.
Main Methods:
- A cross-sectional study involving 34 prepubertal children (aged 4-11 years) with HIV infection.
- Participants included HIV-infected children with GF (n=18), HIV-infected children with normal growth (n=16), and healthy controls (n=52).
- Body composition was assessed using anthropometrics, total body potassium counting for body cell mass (BCM), and dual-energy x-ray absorptiometry for body fat percentage, fat mass, and fat-free mass (FFM).
Main Results:
- HIV-infected boys, regardless of growth status, exhibited significantly lower fat-free mass (FFM)/height ratios compared to healthy boys.
- HIV-infected boys with GF showed a lower body cell mass (BCM)/height ratio than healthy controls; fat measures were largely comparable.
- HIV-infected girls with GF had reduced FFM/height and BCM/height ratios, alongside lower height-for-age and weight-for-age percentiles compared to healthy girls and HIV-infected girls without GF.
Conclusions:
- HIV-associated growth failure (GF) in children is characterized by diminished FFM and BCM, with fat mass remaining relatively normal.
- Decreased FFM was observed in HIV-infected boys even with normal growth, suggesting a potential sex-specific effect of HIV on body composition.
- The preferential loss of FFM and BCM in HIV-infected children mirrors findings in adults with acquired immunodeficiency syndrome (AIDS) wasting.
Objective:
To characterize the body composition of human immunodeficiency virus (HIV)-infected children, especially those with growth failure (GF), using laboratory-based methods.
Design:
A cross-sectional study of body composition measurements.
Setting:
Urban, hospital-based body composition laboratory.
Participants:
Thirty-four prepubertal children with HIV infection, aged 4 to 11 years, recruited from a pediatric HIV clinic. Eighteen HIV-infected children with GF, 16 HIV-infected children with normal rates of growth, and 52 healthy children were studied.
Main Outcome Measurements:
Anthropometrics, body cell mass (BCM) by total body potassium counting, body fat percent, fat mass, and fat-free mass (FFM) by dual-energy x-ray absorptiometry were determined.
Results:
Both groups of boys with HIV infection had significantly lower FFM/height ratios compared with healthy boys. The mean BCM/height ratio was also lower in HIV-infected boys with GF compared with healthy boys. Measures of fat of the HIV-infected boys with GF did not differ from healthy controls, but a statistical trend suggesting decreased body fat percent and fat mass/height ratio was observed in HIV-infected boys without GF (P=.06 and .07, respectively). Mean height-for-age, weight-for-age, and weight-for-height percentiles were significantly decreased in HIV-infected boys regardless of growth status as compared with healthy boys. The mean FFM/ height and BCM/height ratios were decreased in HIV-infected girls with GF compared with healthy girls. Body fat percentage and fat mass/height ratio did not differ among the 3 groups of girls. The mean weight-for-height percentiles were not different among the 3 groups of girls. The HIV-infected girls with GF had significantly lower mean height-for-age and weight-for-age percentiles than HIV-infected girls without GF and healthy girls. The mean height-for-age percentiles of the HIV-infected girls with GF did not differ from the healthy girls.
Conclusions:
Boys and girls with HIV-associated GF had diminished FFM and BCM. The decrease in FFM and BCM was in striking contrast to the fat compartment, which was normal. Decreased FFM was also detected in boys with HIV infection and normal growth but not in girls with HIV infection and normal growth, suggesting that HIV infection may affect boys differently than girls. The preferential decrease in FFM and BCM over fat observed in these children is similar to findings reported in adults with acquired immunodeficiency syndrome wasting.
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