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Thyroid function and nutritional status in HIV-infected children
NUTRITION AND HIV INFECTION-POSTER
PRESENTATIONS
P-33 C FUNDARO, 0 GENOVESE, C RENDELI, A OLIVIERI, M SORCINI, M D’ARCHIVIO, A PLEBANI, G SEGNI Catholic University of Rome, Large A. Gemelli, n. 8, 00168 Rome ITALY THYROID FUNCTION AND NUTRITIONAL STATUS IN HIV-INFECTED CHILDREN Objective. Aim of the study is to evaluate the thyroid abnormalities in a malnourished pediatric HIV+ population. Patients and methods. 73 children were enrolled in the study: 31 with perinatal HIV infection (16 males and 15 females), 18 horn to HIV+ mother who seroreverted and 24 healthy as control group. HIV infected patients were dicided into two groups. Group I included 14 malnourished subjects (Waterlow criteria: class l-3); group 2, 17 without impairment of nutritional status (Waterlow criteria: class 0). Plasma concentrations of triiodothyronine (T3 ) , thyroid-stimulating hormone (TSH) and thyroxine-binding globulin (TBG) were measured using RIA method. Results. T3 values were increased in 3113 (21,4%) children of group 1, in IO/ 17 (58.8%) of group 2, in 6118 (30%) of seroreverted children and in 9/24 (37.5%) of healthy controls. TSH values were increased in 8/14 (57.1%) children of group 1, in 5/17 (29.4%) of group 2, in 4/18 (22%) of seroreverted children and none of healthy controls. TBG levels were increased in 7/ 12 (58.3%) children of group 1, in 9/15 (60%) of group 2, in 4/18 (22%) seroreverted and 2124 (8.3%) of healthy controls. Conclusions. The present study shows a significant increase of TSH levels in malnourished HIV+ children versus healthy controls and seroreverted children. TBG levels is increased in HIV+ children despite of nutritional status. No significant differences were noted regarding T3 levels in both groups. A follow-up study will be necessary to evaluate the possible relation between the malnutrition and thyroid pattern.
287
P-34 M FEREGRINO-GOYOS, A KIMURA-OVANDO, WH GOMEZ-CARO, RC ALVARADO-DIEZ, GLN GOMEZ-MORA, FJ HIGUERA-RAMIREZ, H HIDALGO, MP MIRELES VIEYRA CITAID SC, Lago Ontario # 15, Tacuba Mexico City, FD 11410 MEXICO ANOREXIA IN AIDS: MANAGEMENT WITH MEGESTROL ACETATE, AND ENTERAL NUTRITIONAL SUPPORT WITH 2.0 KCALIML HIGH N FORMULAS: A PILOT STUDY OPEN, NOT CONTROLLED AND VOLUNTARY ACCESS Purpose of the sudy, introduction and objectives: Anorexia plays one of the first factors in wasting syndrome in AIDS Gastric emptying is reduced. Taste perversion , hypotalamic disorders, infections, high viral load, dementia and vomiting are also important factors. For a long time TPN had very high cost and metabolic problems, and nasojejunal line was not accepted in most patients. Megestrol acetate has increased the appetite of the AIDS patient, and a solution high in caloric content and nitrogen in small volume may be a solution. Methods: In a pilot not controlled, open access, clinical and observational, transvers clinical trial with ANOVA evaluation was completed in 60 patients with VIH +, and advanced AIDS who had anorexia with an average of caloric intake of 400-700 kcallday who didn’t accept gastrostomy or nasojejunal tube feeding supplementation. All the patients had proved problems in gastric empty and 90% chronic 0.1. in treatment, and antiviral treatment in course. The study included: a signed letter of consent, no respiratory, hepatic or cardiac problems, and excluded criterion for TPN. Diarrhea or malabsortion syndrome were not included. Pregnancy was excluded. Evaluation with ANOVA in these endpoint were done: Weight lost before and weigh gain after 30 days of treatment for 90 days. CD4 basal counts 0.1. Course of treatment and caloric intake average before and after treatment. Kamofsky index before and after and anthropometric evaluation monthly and 32 studies of chemical screens were done monthly. Tolerance of the formula evaluated. Results: 60 adult patient HIV + included. Age av. 35.5 yr, Male/female (57/3), Basal CD4 count was 4033. Basal caloric intake was 4502300 kcal/day 100% under antiviral treatment and treatment of 0.1. CMV 18 (33%), mycobacterias Toxo or Cryptococcus sequelaes in 20%. treated 15 (25%). Candida (lo%), Weight lost -20 kg (35% of habitual weight (p
PRESENTATIONS
P-33 C FUNDARO, 0 GENOVESE, C RENDELI, A OLIVIERI, M SORCINI, M D’ARCHIVIO, A PLEBANI, G SEGNI Catholic University of Rome, Large A. Gemelli, n. 8, 00168 Rome ITALY THYROID FUNCTION AND NUTRITIONAL STATUS IN HIV-INFECTED CHILDREN Objective. Aim of the study is to evaluate the thyroid abnormalities in a malnourished pediatric HIV+ population. Patients and methods. 73 children were enrolled in the study: 31 with perinatal HIV infection (16 males and 15 females), 18 horn to HIV+ mother who seroreverted and 24 healthy as control group. HIV infected patients were dicided into two groups. Group I included 14 malnourished subjects (Waterlow criteria: class l-3); group 2, 17 without impairment of nutritional status (Waterlow criteria: class 0). Plasma concentrations of triiodothyronine (T3 ) , thyroid-stimulating hormone (TSH) and thyroxine-binding globulin (TBG) were measured using RIA method. Results. T3 values were increased in 3113 (21,4%) children of group 1, in IO/ 17 (58.8%) of group 2, in 6118 (30%) of seroreverted children and in 9/24 (37.5%) of healthy controls. TSH values were increased in 8/14 (57.1%) children of group 1, in 5/17 (29.4%) of group 2, in 4/18 (22%) of seroreverted children and none of healthy controls. TBG levels were increased in 7/ 12 (58.3%) children of group 1, in 9/15 (60%) of group 2, in 4/18 (22%) seroreverted and 2124 (8.3%) of healthy controls. Conclusions. The present study shows a significant increase of TSH levels in malnourished HIV+ children versus healthy controls and seroreverted children. TBG levels is increased in HIV+ children despite of nutritional status. No significant differences were noted regarding T3 levels in both groups. A follow-up study will be necessary to evaluate the possible relation between the malnutrition and thyroid pattern.
287
P-34 M FEREGRINO-GOYOS, A KIMURA-OVANDO, WH GOMEZ-CARO, RC ALVARADO-DIEZ, GLN GOMEZ-MORA, FJ HIGUERA-RAMIREZ, H HIDALGO, MP MIRELES VIEYRA CITAID SC, Lago Ontario # 15, Tacuba Mexico City, FD 11410 MEXICO ANOREXIA IN AIDS: MANAGEMENT WITH MEGESTROL ACETATE, AND ENTERAL NUTRITIONAL SUPPORT WITH 2.0 KCALIML HIGH N FORMULAS: A PILOT STUDY OPEN, NOT CONTROLLED AND VOLUNTARY ACCESS Purpose of the sudy, introduction and objectives: Anorexia plays one of the first factors in wasting syndrome in AIDS Gastric emptying is reduced. Taste perversion , hypotalamic disorders, infections, high viral load, dementia and vomiting are also important factors. For a long time TPN had very high cost and metabolic problems, and nasojejunal line was not accepted in most patients. Megestrol acetate has increased the appetite of the AIDS patient, and a solution high in caloric content and nitrogen in small volume may be a solution. Methods: In a pilot not controlled, open access, clinical and observational, transvers clinical trial with ANOVA evaluation was completed in 60 patients with VIH +, and advanced AIDS who had anorexia with an average of caloric intake of 400-700 kcallday who didn’t accept gastrostomy or nasojejunal tube feeding supplementation. All the patients had proved problems in gastric empty and 90% chronic 0.1. in treatment, and antiviral treatment in course. The study included: a signed letter of consent, no respiratory, hepatic or cardiac problems, and excluded criterion for TPN. Diarrhea or malabsortion syndrome were not included. Pregnancy was excluded. Evaluation with ANOVA in these endpoint were done: Weight lost before and weigh gain after 30 days of treatment for 90 days. CD4 basal counts 0.1. Course of treatment and caloric intake average before and after treatment. Kamofsky index before and after and anthropometric evaluation monthly and 32 studies of chemical screens were done monthly. Tolerance of the formula evaluated. Results: 60 adult patient HIV + included. Age av. 35.5 yr, Male/female (57/3), Basal CD4 count was 4033. Basal caloric intake was 4502300 kcal/day 100% under antiviral treatment and treatment of 0.1. CMV 18 (33%), mycobacterias Toxo or Cryptococcus sequelaes in 20%. treated 15 (25%). Candida (lo%), Weight lost -20 kg (35% of habitual weight (p