RESTING ENERGY-EXPENDITURE AND BODY-COMPOSITION IN CHILDREN WITH HIV-INFECTION

The purpose of this study was to determine whether alterations in body composition, resting energy expenditure (REE), and dietary energy int ake are associated with growth retardation in HIV-positive children. B ody composition (deuterium oxide dilution, skinfold measurements), REE (indirect calorimetry), and energy intake (24-hour weighed food intak e) were evaluated in three groups: HIV-positive with growth retardatio n (HIV+Gr), HIV-positive with normal growth (HIV+); and HIV-uninfected with normal growth (HIV-). Children were between 2 and 11 years of ag e, afebrile, and free from acute infection. Forty-two children (13 HIV +Gr, 19 HIV+, 10 HIV-) were studied. Lean body mass was significantly reduced in HIV+Gr compared with HIV- (p < .05), and fat mass was signi ficantly reduced in HIV+Gr and HIV+ compared with HIV- (p < .05). The percentages of lean and fat mass were not significantly different betw een groups, suggesting that differences in lean and fat mass were prop ortional to differences in body size. Consistent with reduced lean bod y mass, mean REE was significantly lower in HIV+Gr compared with HIV- (p < .05). Differences in mean REE/kg of body weight or lean body mass between groups were not statistically significant. A significant nega tive correlation was found between REE (kcal/kg/day) and weight-for-ag e (p = .04), and a trend with height-for-age Z-score (p = .07). Mean e nergy intake was not significantly different between groups. This stud y suggests that lean and fat mass are proportionately reduced in HIV-p ositive children with growth retardation. Further studies are necessar y to delineate the relationship between energy balance and growth in c hildren with HIV infection.