BODY-COMPOSITION IN PREPUBERTAL CHILDREN WITH HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION

Objective: To characterize the body composition of human immunodeficie ncy virus (HIV)-infected children, especially those with growth failur e (GF), using laboratory-based methods. Design: A cross-sectional stud y of body composition measurements. Setting: Urban, hospital-based bod y composition laboratory. Participants: Thirty-four prepubertal childr en with HIV infection, aged 4 to 11 years, recruited from a pediatric HIV clinic. Eighteen HIV-infected children with GF, 16 HIV-infected ch ildren with normal rates of growth, and 52 healthy children were studi ed. Main Outcome Measurements: Anthropometrics, body cell mass (BCM) b y total body potassium counting, body fat percent, fat mass, and fat-f ree mass (FFM) by dual-energy x-ray absorptiometry were determined. Re sults: Both groups of boys with HIV infection had significantly lower FFM/height ratios compared with healthy boys. The mean BCM/height rati o was also lower in HIV-infected boys with GF compared with healthy bo ys. Measures of fat of the HIV-infected boys with GF did not differ fr om healthy controls, but a statistical trend suggesting decreased body fat percent and fat mass/height ratio was observed in HIV-infected bo ys without GF (P = .06 and .07, respectively). Mean height-for-age, we ight-for-age, and weight-for-height percentiles were significantly dec reased in HIV-infected boys regardless of growth status as compared wi th healthy boys. The mean FFM/height and BCM/height ratios were decrea sed in HIV-infected girls with GF compared with healthy girls. Body fa t percentage and fat mass/height ratio did not differ among the 3 grou ps of girls. The mean weight-for-height percentiles were not different among the 3 groups of girls. The HIV-infected girls with GT; had sign ificantly lower mean height-for-age and weight-for-age percentiles tha n 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 striki ng contrast to the fat compartment, which was normal. Decreased FFM wa s also detected in boys with HIV infection and normal growth but not i n girls with HIV infection and normal growth, suggesting that HIV infe ction may affect boys differently than girls. The preferential decreas e in FFM and BCM over fat observed in these children is similar to fin dings reported in adults with acquired immunodeficiency syndrome wasti ng.