Whole gastrointestinal transit time is associated with clinical severity and nutritional status of HIV-infected children

Abstract

Background: Malnutrition and malabsorption are common consequences in pediatric human immunodeficiency virus (HIV) infection. The gastrointestinal tract is a major site affected by HIV. Rapid gastrointestinal transit time may contribute to malabsorption. Objective: To determine whether the whole gastrointestinal transit time (WGTT) correlates with disease stages or degrees of malnutrition in HIV-infected children. Material and Method: Forty HIV-seropositive children, at various stages of disease, and thirty seronegative age-matched controls, aged between 1 mo and 3 yr, were enrolled in the present study. The body weight, length, or height and the WGTT were assessed. Then the WGTT of children in different stages of HIV disease and in different degrees of malnutrition were compared with those of the control group. Results: The mean ages were 15.5 and 14.3 mo in HIV-infected and control groups respectively. A greater degree of malnutrition was found in HIV-infected children with more advances HIV clinical symptoms. Compared to controls, WGTT was most rapid in severely symptomatic acquired immunodeficiency syndrome (AIDS) patients (Category C) (14.32 + 3.88 versus 7.22 + 3.17 h; p < 0.01) but not in asymptomatic, mildly and moderately symptomatic children. Accelerated WGTT in HIV-infected children was also significantly associated with a higher degree of malnutrition. Conclusion: Malnutrition is clearly related to the progression of HIV disease. Accelerated WGTT is associated with HIV seropositivity, severe clinical symptoms, and higher degrees of malnutrition.