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: 6654581
• 负责人: TRACIE L MILLER
• 金额: $ 19.62万
• 依托单位: TUFTS UNIVERSITY BOSTON
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-01 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6654581
• 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.

在过去的五年中，我们已经成功地收集了100多名HIV感染和控制儿童的增长和营养数据。我们已经确定了这些儿童的生长，身体成分，能量利用，细胞因子生产以及有效的营养干预计划的变化。在这种竞争的续约中，将继续收集有关这种独特的HIV感染儿童队列的生长，身体成分，饮食摄入和能量利用的数据。由于小儿艾滋病毒的面貌是每一次变化，捕获和持续的评估和随访，并在较早的较早治疗方案出现之前，都是无价的。我们将在儿童（CDC A类，B类，C和对照组）中使用13C亮氨酸在HIV的临床范围中使用13C亮氨酸进行全身蛋白质更新研究来定量蛋白质代谢，因为他们知道随着时间的推移，这些儿童的瘦体重下降了。我们将确定蛋白质更新，病毒活性和其他传染性结果之间是否存在关联。同样，随着蛋白酶抑制剂（PI）和其他高度活跃的抗逆转录病毒疗法（HAART）的出现，人体组成和改善的临床结局的变化显而易见。我们将通过人体组成研究来定量和表征这些变化，这些研究研究脂肪分布的区域化，并通过新的疗法进行纵向变化。我们还将确定在这些儿童中是否显而易见葡萄糖代谢，并可能导致脂肪再分配综合征。最后，提出了通过运动计划来增加体重和功能的实用干预措施，既是艾滋病毒，又是儿科的独特之处。我们将确定一项为期12周的运动方案，外部活动的加强是有效地改善艾滋病毒感染儿童的瘦体重，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。