EFFECT OF ENTERAL TUBE-FEEDING ON GROWTH OF CHILDREN WITH SYMPTOMATICHUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Malnutrition and growth failure are frequent clinical consequences of human immunodeficiency virus (HIV) infection in children. Tube feeding is a means by which to increase the enteral intake of nutrients. We e xamined the effect of tube feeding in 18 children, median age 6 months (range, 3-159). Tube feedings were initiated due to growth failure in all, which was also associated with dysfunctional swallowing or aspir ation in seven children and gastroesophageal reflux in two. Tube feedi ngs were infused via nasogastric tube (n = 4) or gastrostomy tube (n = 14) and were continued for a median of 8.5 months (range, 2-24). Stom a complications developed in three children with gastrostomy tubes; th ese were the only tube-related side effect. Tube feedings were discont inued due to noncompliance (n = 3), gastrostomy leakage (n = 2), intol erance (n = 2), and death (n = 3). Anthropometric changes were evaluat ed comparing mean standard deviation scores (Z) before and after tube feeding. Tube feeding resulted in significantly increased weight for a ge (Z, - 2.13 +/- 0.7 vs. - 1.46 +/- 1.4; p = 0.04), weight for height (Z, -1.07 +/- 1.0 vs. -0.13 +/- 1.0; p = 0.004), and arm fat area (Z, -1.75 +/- 1.3 vs. -0.62 +/- 1.2; p = 0.01). However, tube feeding did not result in significant changes in height for age (Z, -1.93 +/- 0.8 vs. -1.74 +/- 1.6) or arm muscle area (Z, -1.24 +/- 0.9 vs. -0.57 +/- 1.2). Tube feedings effectively increased the weight of HIV-infected children in this study, but they were not sufficient to correct linear growth deficits.