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[Role of tumor necrosis factor-a, nitric oxide and markers of clinical progression in the nutritional status of children with vertically-acquired hiv-1infection].

OBJECTIVE
To study the correlation between the immunologic and virologic markers of clinical progression and the nutritional status of children with vertically acquired HIV-1infection.


MATERIAL AND METHODS
We performed an anthropometric study in 34 HIV-1infected children. T cell subpopulations were analyzed by flow cytometry. Viral load (VL) was quantified by a standard commercial molecular assay. Tumor necrosis factor (TNF-) and nitric oxide (NO) concentrations were quantified by enzyme immunoassay.


RESULTS
Z-weight, Z-height, Z-Quetelet index, Z-tricipital pleat, Z-arm perimeter, Z-cephalic perimeter, and McLaren's nutritional index were negatively correlated with VL. These anthropometric parameters were positively correlated with the percentage of CD4T lymphocytes but the correlation between these parameters and VL was lower. HIV-1infected children with a VL> 5 log 10 showed higher TNF- and NO concentrations and lower anthropometric scores. TNF- and NO concentrations were significantly higher in HIV-1infected children with a VL>5 log 10 than in those with a VL<5 log 10. TNF- and NO concentrations were significantly lower in HIV-1infected children undergoing antiretroviral treatment than in untreated HIV-1infected children. TNF- and NO concentrations were significantly higher in the HIV-1infected children than in the control group.


CONCLUSIONS
Our data suggest an association between anthropometric characteristics indicating the nutritional status of HIV-1infected children and immunologic and virologic markers of clinical progression (percentage of CD 4T lymphocytes and VL). Moreover, TNF- and NO play a significant role in the nutritional status and neurological alterations of these children.