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Faecal Calprotectin in HIV-infected, HAART-naïve Ugandan Children

Hestvik, E.*; Olafsdottir, E.; Tylleskar, T.*; Aksnes, L.; Kaddu-Mulindwa, D.§; Ndeezi, G.; Tumwine, J.K.; Grahnquist, L.||

Journal of Pediatric Gastroenterology and Nutrition: June 2012 - Volume 54 - Issue 6 - p 785–790
doi: 10.1097/MPG.0b013e318241a683
Original Articles: Gastroenterology

Objectives: Calprotectin is a calcium- and zinc-binding protein and a marker in faeces of gastrointestinal inflammation. Reference values have been established in children older than 4 years. The aim of the present study was to determine the concentration of faecal calprotectin (FC) in human immunodeficiency virus (HIV)–infected, highly active antiretroviral therapy–naïve Ugandan children and compare it with the reference value.

Methods: We tested 193 HIV-infected children ages 0 to 12 years in a hospital-based survey for FC. A standardised interview with sociodemographic information and medical history was used to assess risk factors. A cluster of differentiation 4 (CD4) cell percentage was prevalent in all of the children.

Results: The median FC concentrations decreased with increasing age, as in healthy children. The median concentration was 208 mg/kg in infants 0 to 1 year, 171 mg/kg among toddlers 1 to 4 years, and 62 mg/kg for children 4 to 12 years. Children with advanced disease and a low CD4 cell percentage had significantly higher FC concentrations than those with a high CD4 cell percentage. Children older than 4 years with diarrhoea had significantly higher FC concentrations compared with those without diarrhoea.

Conclusions: HIV-infected children older than 4 years had a median FC concentration above the reference value, and gut inflammation in the children with elevated values is likely. Children with more advanced disease had increased FC concentrations regardless of age.

*Centre for International Health, University of Bergen

Department of Paediatrics, Haukeland University Hospital, Bergen, Norway

Department of Paediatrics and Child Health

§Department of Microbiology, Makerere University School of Medicine, College of Health Sciences, Kampala, Uganda

||Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden

Department of Clinical Medicine, University of Bergen, Bergen, Norway.

Address correspondence and reprint requests to E. Hestvik, Centre for International Health, University of Bergen, Postboks 7804, N0-5020 Bergen, Bergen, Norway (e-mail:

Received 18 April, 2011

Accepted 7 November, 2011

The present study received funding from the University of Bergen and the GlobVac programme by the Research Council of Norway, grant no. 172226 Focus on Nutrition and Child Health: Intervention Studies in Low-income Countries.

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN