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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Effects of HIV infection on the metabolic and hormonal status of children with severe acute malnutrition
PLoS ONE, Volume 9, No. 7, Article e102233, Year 2014
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Description
Background: HIV infection occurs in 30% of children with severe acute malnutrition in sub-Saharan Africa. Effects of HIV on the pathophysiology and recovery from malnutrition are poorly understood. Methods: We conducted a prospective cohort study of 75 severely malnourished Ugandan children. HIV status/CD4 counts were assessed at baseline; auxologic data and blood samples were obtained at admission and after 14 days of inpatient treatment. We utilized metabolomic profiling to characterize effects of HIV infection on metabolic status and subsequent responses to nutritional therapy. Findings: At admission, patients (mean age 16.3 mo) had growth failure (mean W/H z-score -4.27 in non-edematous patients) that improved with formula feeding (mean increase 1.00). 24% (18/75) were HIV-infected. Nine children died within the first 14 days of hospitalization; mortality was higher for HIV-infected patients (33% v. 5%, OR = 8.83). HIV-infected and HIV-negative children presented with elevated NEFA, ketones, and even-numbered acylcarnitines and reductions in albumin and amino acids. Leptin, adiponectin, insulin, and IGF-1 levels were low while growth hormone, cortisol, and ghrelin levels were high. At baseline, HIV-infected patients had higher triglycerides, ketones, and even-chain acylcarnitines and lower leptin and adiponectin levels than HIV-negative patients. Leptin levels rose in all patients following nutritional intervention, but adiponectin levels remained depressed in HIV-infected children. Baseline hypoleptinemia and hypoadiponectinemia were associated with increased mortality. Conclusions: Our findings suggest a critical interplay between HIV infection and adipose tissue storage and function in the adaptation to malnutrition. Hypoleptinemia and hypoadiponectinemia may contribute to high mortality rates among malnourished, HIV-infected children. © 2014 Mody et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC4106836/bin/pone.0102233.s001.doc
Authors & Co-Authors
Mody, Aaloke
United States, Durham
Duke University Medical Center
Bartz, Sarah
United States, Durham
Duke University Medical Center
Hornik, Christoph P.
United States, Durham
Duke University Medical Center
Kiyimba, Tonny
Uganda, Kampala
Mulago Hospital
Bain, James R.
United States, Durham
Duke University Medical Center
Muehlbauer, Michael J.
United States, Durham
Duke University Medical Center
Kiboneka, Elizabeth
Uganda, Kampala
Mulago Hospital
Stevens, Robert D.
United States, Durham
Duke University Medical Center
St. Peter, John V.
United States, New York
Pepsico, Inc.
Newgard, Christopher B.
United States, Durham
Duke University Medical Center
Bartlett, John A.
United States, Durham
Duke University Medical Center
Freemark, Michael S.
United States, Durham
Duke University Medical Center
Statistics
Citations: 22
Authors: 12
Affiliations: 3
Identifiers
Doi:
10.1371/journal.pone.0102233
e-ISSN:
19326203
Research Areas
Food Security
Infectious Diseases
Maternal And Child Health
Noncommunicable Diseases
Study Design
Randomised Control Trial
Cohort Study
Study Approach
Quantitative