Castaldo A, Tarallo L, Palomba E, Albano F, Russo S, Zuin G, Buffardi F, Guarino A
Department of Pediatrics, University Federico II, Naples, Italy.
J Pediatr Gastroenterol Nutr. 1996 May;22(4):359-63. doi: 10.1097/00005176-199605000-00004.
Children with human immunodeficiency virus (HIV) infection have a higher prevalence of intestinal malabsorption. Anemia is also a common feature in these children. The aims of this work were (a) to establish the prevalence of iron deficiency in HIV-infected children, (b) to test the hypothesis that iron deficiency is related to intestinal malabsorption, (c) to see whether it may contribute to anemia, and (d) to evaluate the sensitivity of oral iron load in the investigation of intestinal function. To accomplish these goals, 71 HIV-infected symptomatic children were enrolled. Iron serum values were determined before and after oral load with ferrous sulfate. The correlation between basal and post-load iron levels was evaluated by linear regression. Xylose level after oral load, fecal fat, and fecal alpha 1-antitrypsin concentration were also determined. Iron deficiency was detected in 48% of patients, and it was significantly associated with intestinal iron malabsorption. Sugar malabsorption, steatorrhea, and fecal protein loss were detected in 26, 36, and 17% of patients, respectively. Low hemoglobin levels were detected in 66% of patients. The majority of children with iron deficiency also had anemia. Preliminary data showed that oral iron administration was sufficient for raising hemoglobin in children with normal iron absorption, whereas parenteral administration was required in those with iron malabsorption. We conclude that (a) iron deficiency is a major feature of pediatric HIV infection, (b) it is related to intestinal malabsorption, and (c) it contributes to anemia. Finally, oral iron load is a sensitive test for investigating intestinal function.
感染人类免疫缺陷病毒（HIV）的儿童肠道吸收不良的患病率较高。贫血也是这些儿童的一个常见特征。这项研究的目的是：（a）确定HIV感染儿童缺铁的患病率；（b）检验缺铁与肠道吸收不良有关的假设；（c）观察缺铁是否会导致贫血；（d）评估口服铁负荷在肠道功能检查中的敏感性。为实现这些目标，招募了71名有症状的HIV感染儿童。在口服硫酸亚铁负荷前后测定血清铁值。通过线性回归评估基础铁水平和负荷后铁水平之间的相关性。还测定了口服负荷后木糖水平、粪便脂肪和粪便α1-抗胰蛋白酶浓度。48%的患者检测到缺铁，且缺铁与肠道铁吸收不良显著相关。分别有26%、36%和17%的患者检测到糖吸收不良、脂肪泻和粪便蛋白丢失。66%的患者检测到血红蛋白水平低。大多数缺铁儿童也患有贫血。初步数据表明，口服铁剂对铁吸收正常的儿童足以提高血红蛋白水平，而铁吸收不良的儿童则需要胃肠外给药。我们得出以下结论：（a）缺铁是儿童HIV感染的一个主要特征；（b）缺铁与肠道吸收不良有关；（c）缺铁会导致贫血。最后，口服铁负荷是一种用于检查肠道功能的敏感试验。
