Malnutrition and carbohydrate malabsorption in children with vertically transmitted human immunodeficiency virus 1 infection.

Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.

Malnutrition and carbohydrate malabsorption in children with vertically transmitted human immunodeficiency virus 1 infection.

Gastroenterology. 1991 May;100(5 Pt 1):1296-302. Unique Identifier : AIDSLINE MED/91192522
Miller TL; Orav EJ; Martin SR; Cooper ER; McIntosh K; Winter HS; Combined Program in Pediatric Gastroenterology and Nutrition; Children's Hospital, Boston, Massachusetts.

Abstract: The nutritional needs of children with human immunodeficiency virus infection are poorly understood. Twenty-eight children with vertically transmitted human immunodeficiency virus infection were evaluated for carbohydrate malabsorption using lactose hydrogen breath tests and d-xylose absorption studies. Lactose malabsorption was a common finding in human immunodeficiency virus-infected children and occurred in 8 of 20 patients who had no identifiable enteric pathogen. Lactose malabsorption occurred at an earlier age in human immunodeficiency virus-infected children than in an age-matched group of 45 symptomatic control children (P = 0.02). However, lactose malabsorption was not associated with higher rates of diarrhea or growth failure. Abnormalities in d-xylose absorption were not significantly associated with either diarrhea or growth failure. However, 39% of d-xylose studies (9 of 23) showed abnormal results and were significantly associated with enteric infections (P = 0.004). Abnormalities in small-bowel morphology were found in 4 of 9 children with growth failure, 3 of whom had an enteric infection and low d-xylose absorption. Lactose hydrogen breath testing and d-xylose testing showed carbohydrate malabsorption in 61% of children (17 of 28). This study demonstrates that human immunodeficiency virus-infected children are at risk for malabsorptive disorders, which are not always related to clinical symptoms. We speculate that human immunodeficiency virus may be directly involved in the development of lactose malabsorption. Carbohydrate malabsorption in human immunodeficiency virus-infected children may not be the only factor responsible for growth failure.

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/TRANSMISSION Breath Tests Carbohydrates/*METABOLISM Child Gastrointestinal Diseases/ETIOLOGY Growth Disorders/ETIOLOGY Human *HIV-1 Infant Lactose Intolerance/ETIOLOGY Malabsorption Syndromes/DIAGNOSIS/*ETIOLOGY Nutrition Disorders/*ETIOLOGY Support, U.S. Gov't, P.H.S. Xylose/METABOLISM JOURNAL ARTICLE
910730
M9170345

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