Prospective analysis of patterns of weight change in stage IV human immunodeficiency virus infection

Macallan, Derek C.; Noble, C.J.; Baldwin, Christine; Foskett, Marianne; McManus, Thomas J.; Griffin, George E.

doi:10.1093/ajcn/58.3.417

Cited by 154 publications

(60 citation statements)

References 22 publications

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“…Em adultos infectados pelo HIV, o GER foi avaliado em diversos estudos 4,10,13,20,21 . Hommes et al, em 1991, encontraram um aumento de 8%, em relação a um grupo controle.…”

Section: Resultsunclassified

Energy balance in infants born from HIV seropositive mothers

Hamamoto¹,

Cardoso²,

Marques³

et al. 2000

J Pediatr (Rio J)

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Objectives: A nutritional evaluation of infants born from HIV seropositive mothers was carried out during their follow up and diagnostic investigation. The energy balance (EB) of infected and noninfected children were compared.Methods: The energy balance (intake energy, fecal energy, and resting energy expenditure) was prospectively determined by indirect calorimetry, considering 13 infants (6 girls and 7 boys) between 1 and 6 months of age, born from HIV positive mothers. This was made in two opportunities: before and after the diagnosis of the disease. A full nutritional assessment, including clinical examination and anthropometric measures (weight, height and skinfold thickness), was also determined in these two opportunities. After the definite diagnosis, the infants were finally assembled in 2 different groups: infected (5 in 13) and noninfected (8 in 13). The children were monthly submitted to clinical evaluations and orientation, during all the study.Results: By analyzing the anthropometric measures of the two groups, it was observed that the infected group had malnutritional manifestations since the first evaluation. The resting energy expenditure (kcal/kg/dia) of the infected group was higher than that of the noninfected group: 64.5+16.8 vs 48.0+5.7 (p<0.05) at the first evaluation and 68.0+11.7 vs 51.8+3.1 (p<0.05) at the second, respectively.Conclusion: The higher resting energy expenditure of the children in the infected group might be the cause of the protein energy malnutrition during the asymptomatic phase when the diagnosis was uncertain. ResumoObjetivo: A avaliação nutricional de lactentes filhos de mães soropositivas para o HIV foi efetuada durante seguimento clínico e investigação diagnóstica. Os balanços de energia (BE) das crianças infectadas e não-infectadas pelo HIV foram comparados.Métodos: As determinações dos BE (energia ingerida, energia fecal e gasto energético de repouso, determinados por calorimetria indireta) foram realizadas prospectivamente em 13 lactentes filhos de mães soropositivas para o HIV (6 meninas e 7 meninos), com idades entre 1e 6 meses. Isso ocorreu em duas oportunidades: antes e depois da definição diagnóstica da criança. Uma avaliação nutricional completa, incluindo exame físico e medidas antropométricas (peso, estatura e pregas cutâneas), também foi realizada nessas duas etapas. Com a definição diagnóstica as crianças foram divididas em dois grupos: infectados (5/13) e não infectados (8/13). As crianças foram seguidas em ambulatório durante todo o estudo, e atendidas mensalmente para avaliação clínica e orientação.Resultados: Do ponto de vista antropométrico, as crianças infectadas apresentaram maior comprometimento nutricional nas duas avaliações efetuadas. Os valores médios do gasto energético de repouso em kcal/kg/dia das crianças infectadas foram maiores que aqueles das não infectadas nas duas avaliações, de maneira significante: 64.5+16.8 vs 48.0+5.7 (p<0.05) na primeira e 68.0+11.7 vs 51.8+3.1 (p<0.05) na segunda avaliação, respectivamente.Conclusões...

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“…Em adultos infectados pelo HIV, o GER foi avaliado em diversos estudos 4,10,13,20,21 . Hommes et al, em 1991, encontraram um aumento de 8%, em relação a um grupo controle.…”

Section: Resultsunclassified

Energy balance in infants born from HIV seropositive mothers

Hamamoto¹,

Cardoso²,

Marques³

et al. 2000

J Pediatr (Rio J)

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“…Malabsorption andaor altered metabolism probably also play an important role in the development or persistence of cachexia in AIDS. On the other hand, it was demonstrated that progressive wasting is not a constant phenomenon in AIDS patients and that the development of wasting is usually due to the presence of speci®c diseases, such as diarrhoeal disease (Macallan et al, 1993). Other opportunistic infections and fever may also lead to increased energy and protein needs (Eldridge, 1996), while HIV infection might exert a direct effect on energy balance that varies with the degree of immunosuppression (Sharpstone et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa: Anthropometric and dietary profile

et al. 1999

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Objective: To evaluate the nutritional intake and status of HIV-1 seropositive patients, as well as the relationship between malnutrition and disease stage. Design: A cross-sectional study. Settings: The Immunology Clinic at the Pelonomi Hospital in Bloemfontein, South Africa. Subjects: Eighty-one HIVaAIDS patients in different stages of disease were recruited consecutively from January to May 1995. Eleven of these patients were followed in 1997. Main outcome measures: Anthropometric data including current weight, height, triceps skinfold thickness, midupper-arm circumference, body mass index and bone-free arm muscle area were collected. Nutrient intake was estimated using a diet history in combination with a standardised food frequency questionnaire. The patients were divided into 3 groups according to their CD4 T cell counts. Results: The men were leaner (BMI 18.9) than the women (BMI 22.7) and patients with a CD4T cell count`200 (stage III) tended to have the lowest median values for all anthropometric measurements. More than half the patients had a low intake (`67% of the recommended dietary allowances) of vitamin C, vitamin B 6 , vitamin D, vitamin A, calcium, iron and zinc. Conclusions: The results con®rms that HIVaAIDS patients from this population are malnourished. There was, however, no association between disease stage and nutritional status. Nutritional supplementation of HIVaAIDS patients should be considered, as this might lead to improved immune function in these patients.

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“…Whereas acute weight loss in AIDS is more often associated with non gastrointestinal infections such pneumonia, opportunistic infection of the small intestine characteristically causes chronic disease with diarrhoea and malabsorption, and around 70% of chronic weight loss is associated with gastrointestinal infection and diarrhoea (Macallan et al 1993). Opportunistic parasitic gut infections cause severe diarrhoea and profoundly compromised small bowel absorptive function (Kapembwa et al 1990) and cause significant mortality in AIDS both in Western (Levine et al 1991) and developing countries (Gilks et al 1990).…”

Section: Hiv and The Gastrointestinal Tractmentioning

confidence: 99%