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Micronutrients and T-cell subsets: a comparison between HIV-infected and uninfected, severely malnourished Rwandan children

Ndagije, F., Baribwira, C. and Coulter, John B.S. (2007) 'Micronutrients and T-cell subsets: a comparison between HIV-infected and uninfected, severely malnourished Rwandan children'. Annals of Tropical Paediatrics, Vol 27, Issue 4, pp. 269-275.

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Objective: To determine the levels of CD4+ cells and micronutrients in HIV-infected and uninfected severely malnourished children.
Design: Cross-sectional study in two centres.
Setting: Children admitted to the malnutrition units in Kigali and Butare, Rwanda.
Patients: A total of 112 children aged 2 months to 5 years presenting with severe malnutrition (weight for height Z-score -3 SD +/- oedema). Fifty-two (46.4%) were HIV-infected.
Methods: CD4+ counts, selenium, zinc and copper levels were measured. The percentage of CD4 cells was calculated as a proportion of total lymphocyte count.
Results: The mean age of the 52 HIV-infected children (18 months) was lower than of the 60 uninfected children (26 months) (p=0.01). Six (11.5%) of the HIV-infected had oedematous malnutrition compared with 50% of the uninfected group. The mean (SD) CD4+ count was 1054 (780) in the HIV-infected and 1579 (721) in the uninfected group (p=0.001). The CD4+ count was also significantly lower in the HIV-infected group than in the uninfected group for the ages <12 mths (p=0.09), 12-24 mths (p=0.045) and >36 mths (p=0.001). In HIV-infected children, 17% had severe immunosuppression (<15% CD4+ cells), 33% moderate (15-24%) and 50% had none (>25%) compared with 9%, 12% and 80% in the HIV-uninfected group, respectively (p<0.001). Approximately one-third in both groups had low levels of selenium and zinc and 77% had raised levels of copper. In multivariate analysis there was significant correlation between selenium and CD4+ (r=0.36, p<0.001) in HIV-infected children and no correlation of zinc and copper to CD4+%. In HIV uninfected children, CD4+% was related to selenium (r=0.282, p=0.03) and to zinc (r=0.264, p=0.047) but not to copper.
Conclusions: In severely malnourished children with HIV infection, low CD4+ levels are associated mainly with HIV infection. There was no significant difference in levels of selenium, zinc and copper between HIV-infected and uninfected children.

Item Type: Article
Uncontrolled Keywords: immunodeficiency-virus type-1 zinc supplementation severe malnutrition selenium deficiency controlled-trial syndrome aids risk progression pneumonia mortality
Subjects: WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.5 Complications
WS Pediatrics > Child Care. Nutrition. Physical Examination > WS 130 In childhood
WS Pediatrics > Diseases of Children and Adolescents > General Diseases > WS 200 General works
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI):
Related URLs:
Depositing User: Pauline Anderson
Date Deposited: 19 Nov 2010 15:14
Last Modified: 06 Feb 2018 13:01


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