SidaSubSaharaV1, Main, Exploration, bibRecord, 000556

Malnutrition in HIV-Infected Children Is an Indicator of Severe Disease with an Impaired Response to Antiretroviral Therapy.

Identifieur interne : 000556 ( Main/Exploration ); précédent : 000555; suivant : 000557

Malnutrition in HIV-Infected Children Is an Indicator of Severe Disease with an Impaired Response to Antiretroviral Therapy.

Source :

AIDS research and human retroviruses [ 1931-8405 ] ; 2017.

RBID : pubmed:28670966

Abstract

This observational study aimed to describe immunopathogenesis and treatment outcomes in children with and without severe acute malnutrition (SAM) and HIV-infection. We studied markers of microbial translocation (16sDNA), intestinal damage (iFABP), monocyte activation (sCD14), T-cell activation (CD38, HLA-DR) and immune exhaustion (PD1) in 32 HIV-infected children with and 41 HIV-infected children without SAM prior to initiation of antiretroviral therapy (ART) and cross-sectionally compared these children to 15 HIV-uninfected children with and 19 HIV-uninfected children without SAM. We then prospectively measured these markers and correlated them to treatment outcomes in the HIV-infected children at 48 weeks following initiation of ART. Plasma levels of 16sDNA, iFABP and sCD14 were measured by quantitative real time PCR, ELISA and Luminex, respectively. T cell phenotype markers were measured by flow cytometry. Multiple regression analysis was performed using generalized linear models (GLMs) and the least absolute shrinkage and selection operator (LASSO) approach for variable selection. Microbial translocation, T cell activation and exhaustion were increased in HIV-uninfected children with SAM compared to HIV-uninfected children without SAM. In HIV-infected children microbial translocation, immune activation, and exhaustion was strongly increased but did not differ by SAM-status. SAM was associated with increased mortality rates early after ART initiation. Malnutrition, age, microbial translocation, monocyte, and CD8 T cell activation were independently associated with decreased rates of CD4% immune recovery after 48 weeks of ART. SAM is associated with increased microbial translocation, immune activation, and immune exhaustion in HIV-uninfected children and with worse prognosis and impaired immune recovery in HIV-infected children on ART.

DOI: 10.1089/AID.2016.0261
PubMed: 28670966

Affiliations:

Le document en format XML

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<author><name sortKey="Muenchhoff, Maximilian" sort="Muenchhoff, Maximilian" uniqKey="Muenchhoff M" first="Maximilian" last="Muenchhoff">Maximilian Muenchhoff</name>
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<author><name sortKey="Healy, Michael" sort="Healy, Michael" uniqKey="Healy M" first="Michael" last="Healy">Michael Healy</name>
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<author><name sortKey="Roider, Julia" sort="Roider, Julia" uniqKey="Roider J" first="Julia" last="Roider">Julia Roider</name>
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<author><name sortKey="Groll, Andreas" sort="Groll, Andreas" uniqKey="Groll A" first="Andreas" last="Groll">Andreas Groll</name>
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<author><name sortKey="Kindra, Chirjeev" sort="Kindra, Chirjeev" uniqKey="Kindra C" first="Chirjeev" last="Kindra">Chirjeev Kindra</name>
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<author><name sortKey="Sibaya, Thobekile" sort="Sibaya, Thobekile" uniqKey="Sibaya T" first="Thobekile" last="Sibaya">Thobekile Sibaya</name>
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<author><name sortKey="Moonsamy, Angeline" sort="Moonsamy, Angeline" uniqKey="Moonsamy A" first="Angeline" last="Moonsamy">Angeline Moonsamy</name>
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<country xml:lang="fr">Afrique du Sud</country>
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<author><name sortKey="Mcgregor, Callum" sort="Mcgregor, Callum" uniqKey="Mcgregor C" first="Callum" last="Mcgregor">Callum Mcgregor</name>
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<country xml:lang="fr">Royaume-Uni</country>
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<author><name sortKey="Phan, Michelle Q" sort="Phan, Michelle Q" uniqKey="Phan M" first="Michelle Q" last="Phan">Michelle Q. Phan</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">État de New York</region>
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<author><name sortKey="Palma, Alejandro" sort="Palma, Alejandro" uniqKey="Palma A" first="Alejandro" last="Palma">Alejandro Palma</name>
<affiliation wicri:level="2"><nlm:affiliation>5 Division of Infectious Diseases, Department of Medicine, Columbia University , New York, New York.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">État de New York</region>
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<author><name sortKey="Kloverpris, Henrik" sort="Kloverpris, Henrik" uniqKey="Kloverpris H" first="Henrik" last="Kloverpris">Henrik Kloverpris</name>
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<author><name sortKey="Leslie, Alasdair" sort="Leslie, Alasdair" uniqKey="Leslie A" first="Alasdair" last="Leslie">Alasdair Leslie</name>
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<country xml:lang="fr">Afrique du Sud</country>
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<author><name sortKey="Bobat, Raziya" sort="Bobat, Raziya" uniqKey="Bobat R" first="Raziya" last="Bobat">Raziya Bobat</name>
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<author><name sortKey="Larussa, Philip" sort="Larussa, Philip" uniqKey="Larussa P" first="Philip" last="Larussa">Philip Larussa</name>
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<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Ndung U, Thumbi" sort="Ndung U, Thumbi" uniqKey="Ndung U T" first="Thumbi" last="Ndung'U">Thumbi Ndung'U</name>
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<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>2 HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal , Durban</wicri:regionArea>
<wicri:noRegion>Durban</wicri:noRegion>
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<author><name sortKey="Goulder, Philip" sort="Goulder, Philip" uniqKey="Goulder P" first="Philip" last="Goulder">Philip Goulder</name>
<affiliation wicri:level="3"><nlm:affiliation>1 Department of Paediatrics, University of Oxford , Peter Medawar Building for Pathogen Research, Oxford, United Kingdom .</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
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<author><name sortKey="Sobieszczyk, Magdalena E" sort="Sobieszczyk, Magdalena E" uniqKey="Sobieszczyk M" first="Magdalena E" last="Sobieszczyk">Magdalena E. Sobieszczyk</name>
<affiliation wicri:level="2"><nlm:affiliation>5 Division of Infectious Diseases, Department of Medicine, Columbia University , New York, New York.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Archary, Mohendran" sort="Archary, Mohendran" uniqKey="Archary M" first="Mohendran" last="Archary">Mohendran Archary</name>
<affiliation wicri:level="1"><nlm:affiliation>8 King Edward VIII Hospital , Durban, South Africa .</nlm:affiliation>
<country xml:lang="fr">Afrique du Sud</country>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Malnutrition in HIV-Infected Children Is an Indicator of Severe Disease with an Impaired Response to Antiretroviral Therapy.</title>
<author><name sortKey="Muenchhoff, Maximilian" sort="Muenchhoff, Maximilian" uniqKey="Muenchhoff M" first="Maximilian" last="Muenchhoff">Maximilian Muenchhoff</name>
<affiliation wicri:level="3"><nlm:affiliation>1 Department of Paediatrics, University of Oxford , Peter Medawar Building for Pathogen Research, Oxford, United Kingdom .</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
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<region type="comté" nuts="2">Oxfordshire</region>
</placeName>
</affiliation>
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<author><name sortKey="Healy, Michael" sort="Healy, Michael" uniqKey="Healy M" first="Michael" last="Healy">Michael Healy</name>
<affiliation wicri:level="2"><nlm:affiliation>5 Division of Infectious Diseases, Department of Medicine, Columbia University , New York, New York.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">État de New York</region>
</placeName>
<wicri:cityArea>5 Division of Infectious Diseases, Department of Medicine, Columbia University , New York</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Singh, Ravesh" sort="Singh, Ravesh" uniqKey="Singh R" first="Ravesh" last="Singh">Ravesh Singh</name>
<affiliation wicri:level="1"><nlm:affiliation>2 HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal , Durban, South Africa .</nlm:affiliation>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>2 HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal , Durban</wicri:regionArea>
<wicri:noRegion>Durban</wicri:noRegion>
</affiliation>
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<author><name sortKey="Roider, Julia" sort="Roider, Julia" uniqKey="Roider J" first="Julia" last="Roider">Julia Roider</name>
<affiliation wicri:level="3"><nlm:affiliation>1 Department of Paediatrics, University of Oxford , Peter Medawar Building for Pathogen Research, Oxford, United Kingdom .</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>1 Department of Paediatrics, University of Oxford , Peter Medawar Building for Pathogen Research, Oxford</wicri:regionArea>
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</placeName>
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<author><name sortKey="Groll, Andreas" sort="Groll, Andreas" uniqKey="Groll A" first="Andreas" last="Groll">Andreas Groll</name>
<affiliation wicri:level="3"><nlm:affiliation>7 Department of Mathematics, Ludwig-Maximilians-University of Munich , Munich, Germany .</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>7 Department of Mathematics, Ludwig-Maximilians-University of Munich , Munich</wicri:regionArea>
<placeName><region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
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<author><name sortKey="Kindra, Chirjeev" sort="Kindra, Chirjeev" uniqKey="Kindra C" first="Chirjeev" last="Kindra">Chirjeev Kindra</name>
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<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>8 King Edward VIII Hospital , Durban</wicri:regionArea>
<wicri:noRegion>Durban</wicri:noRegion>
</affiliation>
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<author><name sortKey="Sibaya, Thobekile" sort="Sibaya, Thobekile" uniqKey="Sibaya T" first="Thobekile" last="Sibaya">Thobekile Sibaya</name>
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<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>8 King Edward VIII Hospital , Durban</wicri:regionArea>
<wicri:noRegion>Durban</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Moonsamy, Angeline" sort="Moonsamy, Angeline" uniqKey="Moonsamy A" first="Angeline" last="Moonsamy">Angeline Moonsamy</name>
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<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>2 HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal , Durban</wicri:regionArea>
<wicri:noRegion>Durban</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mcgregor, Callum" sort="Mcgregor, Callum" uniqKey="Mcgregor C" first="Callum" last="Mcgregor">Callum Mcgregor</name>
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<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>1 Department of Paediatrics, University of Oxford , Peter Medawar Building for Pathogen Research, Oxford</wicri:regionArea>
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<region type="comté" nuts="2">Oxfordshire</region>
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<author><name sortKey="Phan, Michelle Q" sort="Phan, Michelle Q" uniqKey="Phan M" first="Michelle Q" last="Phan">Michelle Q. Phan</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">État de New York</region>
</placeName>
<wicri:cityArea>5 Division of Infectious Diseases, Department of Medicine, Columbia University , New York</wicri:cityArea>
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<author><name sortKey="Palma, Alejandro" sort="Palma, Alejandro" uniqKey="Palma A" first="Alejandro" last="Palma">Alejandro Palma</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">État de New York</region>
</placeName>
<wicri:cityArea>5 Division of Infectious Diseases, Department of Medicine, Columbia University , New York</wicri:cityArea>
</affiliation>
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<author><name sortKey="Kloverpris, Henrik" sort="Kloverpris, Henrik" uniqKey="Kloverpris H" first="Henrik" last="Kloverpris">Henrik Kloverpris</name>
<affiliation wicri:level="1"><nlm:affiliation>6 KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH), Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban, South Africa .</nlm:affiliation>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>6 KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH), Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban</wicri:regionArea>
<wicri:noRegion>Durban</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Leslie, Alasdair" sort="Leslie, Alasdair" uniqKey="Leslie A" first="Alasdair" last="Leslie">Alasdair Leslie</name>
<affiliation wicri:level="1"><nlm:affiliation>6 KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH), Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban, South Africa .</nlm:affiliation>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>6 KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH), Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban</wicri:regionArea>
<wicri:noRegion>Durban</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bobat, Raziya" sort="Bobat, Raziya" uniqKey="Bobat R" first="Raziya" last="Bobat">Raziya Bobat</name>
<affiliation wicri:level="1"><nlm:affiliation>8 King Edward VIII Hospital , Durban, South Africa .</nlm:affiliation>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>8 King Edward VIII Hospital , Durban</wicri:regionArea>
<wicri:noRegion>Durban</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Larussa, Philip" sort="Larussa, Philip" uniqKey="Larussa P" first="Philip" last="Larussa">Philip Larussa</name>
<affiliation wicri:level="2"><nlm:affiliation>12 Division of Infectious Diseases, Department of Pediatrics, Columbia University , New York, New York.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">État de New York</region>
</placeName>
<wicri:cityArea>12 Division of Infectious Diseases, Department of Pediatrics, Columbia University , New York</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Ndung U, Thumbi" sort="Ndung U, Thumbi" uniqKey="Ndung U T" first="Thumbi" last="Ndung'U">Thumbi Ndung'U</name>
<affiliation wicri:level="1"><nlm:affiliation>2 HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal , Durban, South Africa .</nlm:affiliation>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>2 HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal , Durban</wicri:regionArea>
<wicri:noRegion>Durban</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Goulder, Philip" sort="Goulder, Philip" uniqKey="Goulder P" first="Philip" last="Goulder">Philip Goulder</name>
<affiliation wicri:level="3"><nlm:affiliation>1 Department of Paediatrics, University of Oxford , Peter Medawar Building for Pathogen Research, Oxford, United Kingdom .</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>1 Department of Paediatrics, University of Oxford , Peter Medawar Building for Pathogen Research, Oxford</wicri:regionArea>
<placeName><settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sobieszczyk, Magdalena E" sort="Sobieszczyk, Magdalena E" uniqKey="Sobieszczyk M" first="Magdalena E" last="Sobieszczyk">Magdalena E. Sobieszczyk</name>
<affiliation wicri:level="2"><nlm:affiliation>5 Division of Infectious Diseases, Department of Medicine, Columbia University , New York, New York.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">État de New York</region>
</placeName>
<wicri:cityArea>5 Division of Infectious Diseases, Department of Medicine, Columbia University , New York</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Archary, Mohendran" sort="Archary, Mohendran" uniqKey="Archary M" first="Mohendran" last="Archary">Mohendran Archary</name>
<affiliation wicri:level="1"><nlm:affiliation>8 King Edward VIII Hospital , Durban, South Africa .</nlm:affiliation>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>8 King Edward VIII Hospital , Durban</wicri:regionArea>
<wicri:noRegion>Durban</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">AIDS research and human retroviruses</title>
<idno type="eISSN">1931-8405</idno>
<imprint><date when="2017" type="published">2017</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">This observational study aimed to describe immunopathogenesis and treatment outcomes in children with and without severe acute malnutrition (SAM) and HIV-infection. We studied markers of microbial translocation (16sDNA), intestinal damage (iFABP), monocyte activation (sCD14), T-cell activation (CD38, HLA-DR) and immune exhaustion (PD1) in 32 HIV-infected children with and 41 HIV-infected children without SAM prior to initiation of antiretroviral therapy (ART) and cross-sectionally compared these children to 15 HIV-uninfected children with and 19 HIV-uninfected children without SAM. We then prospectively measured these markers and correlated them to treatment outcomes in the HIV-infected children at 48 weeks following initiation of ART. Plasma levels of 16sDNA, iFABP and sCD14 were measured by quantitative real time PCR, ELISA and Luminex, respectively. T cell phenotype markers were measured by flow cytometry. Multiple regression analysis was performed using generalized linear models (GLMs) and the least absolute shrinkage and selection operator (LASSO) approach for variable selection. Microbial translocation, T cell activation and exhaustion were increased in HIV-uninfected children with SAM compared to HIV-uninfected children without SAM. In HIV-infected children microbial translocation, immune activation, and exhaustion was strongly increased but did not differ by SAM-status. SAM was associated with increased mortality rates early after ART initiation. Malnutrition, age, microbial translocation, monocyte, and CD8 T cell activation were independently associated with decreased rates of CD4% immune recovery after 48 weeks of ART. SAM is associated with increased microbial translocation, immune activation, and immune exhaustion in HIV-uninfected children and with worse prognosis and impaired immune recovery in HIV-infected children on ART.</div>
</front>
</TEI>
<affiliations><list><country><li>Afrique du Sud</li>
<li>Allemagne</li>
<li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
<region><li>Angleterre</li>
<li>Bavière</li>
<li>District de Haute-Bavière</li>
<li>Oxfordshire</li>
<li>État de New York</li>
</region>
<settlement><li>Munich</li>
<li>Oxford</li>
</settlement>
</list>
<tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Muenchhoff, Maximilian" sort="Muenchhoff, Maximilian" uniqKey="Muenchhoff M" first="Maximilian" last="Muenchhoff">Maximilian Muenchhoff</name>
</region>
<name sortKey="Goulder, Philip" sort="Goulder, Philip" uniqKey="Goulder P" first="Philip" last="Goulder">Philip Goulder</name>
<name sortKey="Mcgregor, Callum" sort="Mcgregor, Callum" uniqKey="Mcgregor C" first="Callum" last="Mcgregor">Callum Mcgregor</name>
<name sortKey="Roider, Julia" sort="Roider, Julia" uniqKey="Roider J" first="Julia" last="Roider">Julia Roider</name>
</country>
<country name="États-Unis"><region name="État de New York"><name sortKey="Healy, Michael" sort="Healy, Michael" uniqKey="Healy M" first="Michael" last="Healy">Michael Healy</name>
</region>
<name sortKey="Larussa, Philip" sort="Larussa, Philip" uniqKey="Larussa P" first="Philip" last="Larussa">Philip Larussa</name>
<name sortKey="Palma, Alejandro" sort="Palma, Alejandro" uniqKey="Palma A" first="Alejandro" last="Palma">Alejandro Palma</name>
<name sortKey="Phan, Michelle Q" sort="Phan, Michelle Q" uniqKey="Phan M" first="Michelle Q" last="Phan">Michelle Q. Phan</name>
<name sortKey="Sobieszczyk, Magdalena E" sort="Sobieszczyk, Magdalena E" uniqKey="Sobieszczyk M" first="Magdalena E" last="Sobieszczyk">Magdalena E. Sobieszczyk</name>
</country>
<country name="Afrique du Sud"><noRegion><name sortKey="Singh, Ravesh" sort="Singh, Ravesh" uniqKey="Singh R" first="Ravesh" last="Singh">Ravesh Singh</name>
</noRegion>
<name sortKey="Archary, Mohendran" sort="Archary, Mohendran" uniqKey="Archary M" first="Mohendran" last="Archary">Mohendran Archary</name>
<name sortKey="Bobat, Raziya" sort="Bobat, Raziya" uniqKey="Bobat R" first="Raziya" last="Bobat">Raziya Bobat</name>
<name sortKey="Kindra, Chirjeev" sort="Kindra, Chirjeev" uniqKey="Kindra C" first="Chirjeev" last="Kindra">Chirjeev Kindra</name>
<name sortKey="Kloverpris, Henrik" sort="Kloverpris, Henrik" uniqKey="Kloverpris H" first="Henrik" last="Kloverpris">Henrik Kloverpris</name>
<name sortKey="Leslie, Alasdair" sort="Leslie, Alasdair" uniqKey="Leslie A" first="Alasdair" last="Leslie">Alasdair Leslie</name>
<name sortKey="Moonsamy, Angeline" sort="Moonsamy, Angeline" uniqKey="Moonsamy A" first="Angeline" last="Moonsamy">Angeline Moonsamy</name>
<name sortKey="Ndung U, Thumbi" sort="Ndung U, Thumbi" uniqKey="Ndung U T" first="Thumbi" last="Ndung'U">Thumbi Ndung'U</name>
<name sortKey="Sibaya, Thobekile" sort="Sibaya, Thobekile" uniqKey="Sibaya T" first="Thobekile" last="Sibaya">Thobekile Sibaya</name>
</country>
<country name="Allemagne"><region name="Bavière"><name sortKey="Groll, Andreas" sort="Groll, Andreas" uniqKey="Groll A" first="Andreas" last="Groll">Andreas Groll</name>
</region>
</country>
</tree>
</affiliations>
</record>

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Malnutrition in HIV-Infected Children Is an Indicator of Severe Disease with an Impaired Response to Antiretroviral Therapy.

Malnutrition in HIV-Infected Children Is an Indicator of Severe Disease with an Impaired Response to Antiretroviral Therapy.

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