Energy balance, viral burden, insulin-like growth factor-1, interleukin-6 and growth impairment in children infected with human immunodeficiency virus

Objective: To determine the relationship between energy metabolism and grow th abnormalities in HIV-infected children and to assess clinical or laborat ory characteristics which may be contributing factors to their growth impai rment. Design: A comparative study. Methods: We measured energy intake by inpatient calorie count/outpatient 24 h food recalls, resting energy expenditure by indirect calorimetry, total energy expenditure by the doubly-labeled water technique, iron metabolism, protein metabolism, and lipid metabolism markers as well as CD4 count, vira l load, insulin-like growth factor-1 (IGF-1), serum interleukin-6 (IL-6), a nd whole blood stimulated IL-6 levels in prepubertal congenitally HIV/-infe cted children with normal and impaired growth patterns. Results and conclusions: Differences in energy expenditures were not found between normal and growth-impaired HIV-infected children. Energy intake but not energy expenditure was significantly reduced when HIV-infected childre n were compared to expected normal values for age and gender. Advanced HIV clinical disease, severe immune suppression, increased viral burden, increa sed IL-6 activity, decreased total serum protein, and decreased IGF-l level s were more likely to be found in HIV-infected children with growth impairm ent in comparison with HIV-infected children with normal growth. (C) 2000 L ippincott Williams & Wilkins.