RESTING ENERGY-EXPENDITURE AND BODY-COMPOSITION IN PEDIATRIC HIV-INFECTION

One of the most striking features of HIV disease is the ''wasting synd rome'' or failure to thrive. Eighty percent of all perinatally HIV-inf ected children fail to grow normally. Objective. Because severe malnut rition increases the morbidity of HIV infection and may shorten the al ready limited life expectancy of this population, we assessed resting energy needs, body composition, and nutrient intake in nine children p erinatally HIV-infected, age 4 months to 4 years. Design, Subjects wer e studied using measurements of resting energy expenditure (REE) by in direct calorimetry, body composition measurements by dual-energy X-ray absorptiometry (DEXA) and skinfolds, nutrient intake analysis by 24-h our recall, and serum protein levels. The HIV-infected children were f ree of secondary opportunistic infection at the time of the study. Sub jects were reevaluated within the following year. Results. REE correla ted well (r = .856) with the predicted value from the World Health Org anization (WHO) equation for basal energy expenditure. Measurement of percent body fat by skinfolds correlated well with DEXA percent body f at (r = .61). There was no significant difference between body fat ass essed from skinfolds compared to published age-matched standards. All subjects met their recommended dietary allowance (RDA) for calories an d protein. All subjects had adequate visceral protein stores for age. Conclusion. Perinatally infected children were not hypermetabolic when not secondarily infected and were able to maintain normal growth with the provision of adequate nutrition.