BODY COMPOSITION AND ENERGY REQUIREMENT IN PEDIATRIC HIV INFECTION

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Although most children with HIV infection will develop growth and nutritional abnormalities, the effects of HIV on body composition nd nutritional requirements are not known. Currently, nutritional therapy is often empiric and not consistent. The aims of this proposal are to determine the components of body composition in the HIV-infected child with more sophisticated techniques and to determine both total and resting energy requirements. Our first goal is to characterize the body compartments using three different methodologies. We have preliminary data on skin fold measurements of HIV-infected children. We will compare measurements from traditional anthropometry with measurements obtained by deuterium isotope dilution (to measure total body water) and bioelectrical impedance analysis. The latter two methods have not been employed in children with HIV infection. The second goal of this project is to study the energy requirements of a small number of HIV infected children and controls, stratified according to CDC classification (a marker of disease severity). Three groups of children will be studied and will undergo simultaneous assessments of both resting and total energy expenditure using indirect calorimetry and the doubly labelled water technique. This pilot project is heavily dependent on the Mass Spectrometry and Biostatistics Cores. We expect that information obtained through this pilot project will improve clinical care and nutritional rehabilitation programs of HIV-infected children and will serve as the basis for rational nutritional intervention protocols.