Growth failure is a frequent and early sign of pediatric HIV infection. In adults with HIV infection, loss of lean body mass is common. The purpose of this study was to evaluate the extent to which lean body mass is maintained in proportion to linear growth in children with HIV infection. Patients consisted of a convenience sample of children with perinatally-acquired HIV infection recruited from the outpatient pediatric HIV clinics in Charleston, SC, and Cincinnati, OH. Control children were recruited in Cincinnati. HIV-infected children were classified according tothe CDC classification system for pediatric HIV infection. Weights and heights were recorded for all children using digital scales and a fixed wall stadiometer. Subjects were scanned using a Hologic QDR-1000/W whole-body scanner with results reported as grams of fat mass, lean mass (LBM), and bone mineral content. Linear growth failure was defined as a height z-score of ≤1.96. There were 88 control children and 30 HIV-infected children enrolled. Of the infected children, 13 were CDC clinical class A, 6 were B, 9 were C, and 1 was N. Eight had linear growth failure. Analysis of covariance using the entire population showed weight to be the strongest correlate of LBM (R2 0.961). Inclusion of HIV infection status, height, and their interaction did not signficantly improve the model (R2 0.969). When matched by height and sex, there was no difference in LBM between patients and the control group (t=0.97, p=0.34), nor was LBM associated with 1) clinical disease status (F=0.639, p=0.64) or 2) the presence of linear growth failure (t=-0.93, p=0.36) in the HIV infected children. The data suggests that children with HIV infection maintain LBM in proportion to their height and may have important implications in designing nutritional support programs for HIV infected children.
