NUTRITIONAL EVALUATION AND INTERVENTION OF HIV INFECTED INFANTS AND CHILDREN

HIV感染婴儿和儿童的营养评估和干预

• 批准号: 6358004
• 负责人: TRACIE L MILLER
• 金额: $ 15.37万
• 依托单位: TUFTS UNIVERSITY BOSTON
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-01 至 2001-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6358004
• 关键词: AIDS therapy; HIV infections; adipose tissue; antiAIDS agent; bioenergetics; blood lipid; body composition; child (0-11); child physical development; clinical research; exercise; functional ability; glucose metabolism; human subject; insulin sensitivity /resistance; longitudinal human study; nutrient intake activity; nutrition; nutrition related tag; pediatric AIDS; pharmacology; protein metabolism

Over the past five years, we have been successfully able to prospectively collect growth and nutrition data on over 100 HIV-infected and control children. We have determined changes in growth, body composition, energy utilization, cytokine production, and effective nutritional intervention programs for these children. In this competing renewal will continue to collect data on growth, body composition, dietary intake, and energy utilization on this unique cohort of HIV-infected children. As the face of pediatric HIV is every changing, capture and continued assessment and follow-up of these children with very early preceding the advent of newer therapeutic regimens is invaluable. We will quantitate protein metabolism through whole body protein turnover studies using 13C leucine in the clinical spectrum of HIV in children (CDC class A,B,C, and controls), knowing that there are significant declines in lean body mass in these children over time. We will determine if there are associations between protein turnover, viral activity, and other infectious outcomes. As well, with the advent of protease inhibitors (PIs) and other highly active anti-retroviral therapies (HAART), changes in body composition and improved clinical outcomes are apparent. We will quantitate and characterize these changes through body composition studies that study regionalization of fat distribution and follow changes longitudinally and with new therapies. We will also determine if abnormal glucose metabolism is apparent in these children and may potentially led to the fat redistribution syndrome. Lastly practical interventions to increase lean body mass and function through exercise programs are proposed and are unique both to HIV, as well as pediatrics in general. We will determine if a 12 week exercise regimen, with reinforcement of outside activities are effective in improving lean body mass, strength, endurance, flexibility, and functional status in HIV-infected children while comparing them to an "attention" control group.

在过去的五年里，我们已经成功地前瞻性地收集了 100 多名艾滋病毒感染者和控制儿童的生长和营养数据。我们已经确定了这些儿童的生长、身体成分、能量利用、细胞因子产生和有效的营养干预计划的变化。在这次竞争更新中，我们将继续收集这一独特的艾滋病毒感染儿童群体的生长、身体成分、饮食摄入和能量利用的数据。由于儿童艾滋病毒的情况不断变化，因此在新的治疗方案出现之前尽早捕获并持续评估和随访这些儿童是非常宝贵的。我们将通过在儿童 HIV 临床谱（CDC A、B、C 级和对照）中使用 13C 亮氨酸的全身蛋白质周转研究来定量蛋白质代谢，因为我们知道随着时间的推移，这些儿童的去脂体重会显着下降。我们将确定蛋白质周转、病毒活性和其他感染结果之间是否存在关联。此外，随着蛋白酶抑制剂（PI）和其他高效抗逆转录病毒疗法（HAART）的出现，身体成分的变化和临床结果的改善是显而易见的。我们将通过身体成分研究来量化和表征这些变化，这些研究研究脂肪分布的区域化并纵向跟踪变化并采用新疗法。我们还将确定这些儿童是否存在明显的葡萄糖代谢异常，并可能导致脂肪重新分布综合症。最后，提出了通过锻炼计划来增加瘦体重和功能的实际干预措施，这对于艾滋病毒和一般儿科来说都是独一无二的。我们将确定为期 12 周的锻炼方案（强化户外活动）是否能有效改善 HIV 感染儿童的去脂体重、力量、耐力、灵活性和功能状态，同时将其与“注意力”对照组进行比较。