Project Details

A novel stable iron isotope method to define iron needs and improve iron nutrition in HIV+ children

Michael Zimmermann, MD

Summary

BACKGROUND: Anemia frequently complicates pediatric HIV infection and predicts disease progression and mortality, but iron requirements and the specific contribution of iron deficiency to anemia in pediatric HIV infection remains uncertain. A novel method based on isotopic dilution of whole body iron labeled with stable, non-radioactive isotopes of iron could directly quantify iron turnover and requirements, as well as iron absorption from interventions. GAP: This method could offer, for the first time, a long-term quantitative measure of iron balance, requirements and absorption from iron interventions, and provide reliable data on which to base nutrition recommendations for pediatric HIV infection. HYPOTHESIS: The hypothesis is that this new method will enable direct quantification of iron turnover and requirements, as well as iron absorption from interventions, in HIV-infected children. METHODS: In step 1, using stable isotope labeled single meal/doses we will quantify the impairment in dietary iron absorption in children with and without HIV infection from an iron fortified maize meal, a lipid-based nutritional supplement and an oral iron supplement. In step 2, we will apply the principle of long-term isotope dilution to quantify the daily iron requirement in children with and without HIV infection. In step 3, we will apply the principle of long-term isotope dilution in a randomized 3-month trial of oral iron supplements in children with and without HIV infection. RESULTS: Pending IMPACT: The findings would provide the evidence base for establishing the daily iron requirement for HIV infected children and for effective and safe iron interventions for this group. Website Link: http://www.humannutrition.ethz.ch

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