Author:
Gonzales Gerard Bryan,Njunge James M.,Gichuki Bonface M.,Wen Bijun,Potani Isabel,Voskuijl Wieger,Bandsma Robert H. J.,Berkley James A.
Abstract
AbstractHIV infection affects up to 30% of children presenting with severe acute malnutrition (SAM) in Africa and is associated with increased mortality. Children with SAM are treated similarly regardless of HIV status, although mechanisms of nutritional recovery in HIV and/or SAM are not well understood. We performed a secondary analysis of a clinical trial and plasma proteomics data among children with complicated SAM in Kenya and Malawi. Compared to children with SAM without HIV (n = 113), HIV-infected children (n = 54) had evidence (false discovery rate (FDR) corrected p < 0.05) of metabolic stress, including enriched pathways related to inflammation and lipid metabolism. Moreover, we observed reduced plasma levels of zinc-α-2-glycoprotein, butyrylcholinesterase, and increased levels of complement C2 resembling findings in metabolic syndrome, diabetes and other non-communicable diseases. HIV was also associated (FDR corrected p < 0.05) with higher plasma levels of inflammatory chemokines. Considering evidence of biomarkers of metabolic stress, it is of potential concern that our current treatment strategy for SAM regardless of HIV status involves a high-fat therapeutic diet. The results of this study suggest a need for clinical trials of therapeutic foods that meet the specific metabolic needs of children with HIV and SAM.
Funder
Fonds Wetenschappelijk Onderzoek
Bill and Melinda Gates Foundation
Thrasher Research Fund
MRC/DfID/Wellcome Trust Joint Global Health Trials scheme
Publisher
Springer Science and Business Media LLC
Cited by
7 articles.
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