[ Vol. 10 No. 2 ] (May - August 2009 )
Nutritional assessment in children with HIV/AIDS

Vanessa Fuchs
Mexico City, Mexico


Nutritionaldeficiency is a common manifestation of HIV disease and results from a variety of factors. Infection with HIV often leads to fever, additional infections, diarrhea, and malabsorption syndrome with contributes to the protein energy malnutrition that causes failure to thrive in children which is in some cases an irreversible situation.

A comprehensive nutritional assessment includes anthropometric measurements of body composition, biochemical measurements of serum proteins, macronutrients, and metabolic parameters, clinical assessment of altered nutritional requirements and measurement of dietary intake. Techniques for measuring body composition may include anthropometry, bioelectric impedance analysis, dual X-ray absorptiometry (DXA), hydrodensitometry, etc.

Experimental comparative studies show that there is a significant difference in body composition in children infected with HIV than uninfected children. Biochemical and immunological data showed significant differences between the two groups.

However, studies show that with a proper nutrition intervention, and in many cases enteral supplementation in children with HIV, patients had similar weight gain compared to uninfected children. Mean increases in Z scores for both subscapular and triceps skinfolds were similar between HIV infected versus uninfected children. 

The above mentioned studies talk about survival children with HIV and nutritional intervention. However, many studies demonstrate that children infected with HIV have a higher mortality and morbidity rate than uninfected children, and a recent meta-analysis showed that macronutrient intervention such as a balanced diet or high protein, high carbohydrate, or high fat diets given orally did not reduce morbidity and mortality in HIV infected children. This evidence is limited to a few small trials in high income countries. 

Being able to identify nutritional deficits on time, linking patients with appropriate medical/nutritional support services, and assuring that appropriate nutritional intervention are implemented is the main step to prevent stunted growth and development.



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PENSA 2009

“Energizing Nutrition Support Practice for Life”
June 5-7 2009, Shangri-La Hotel, Kuala Lumpur, Malaysia 
Page: 31