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Nutritional recovery in HIV-infected and HIV-uninfected children with severe acute malnutrition

Fergusson, P; Chinkhumba, J; Grijalva-Eternod, C; Banda, T; Mkangama, C; Tomkins, A; (2009) Nutritional recovery in HIV-infected and HIV-uninfected children with severe acute malnutrition. ARCH DIS CHILD , 94 (7) 512 - 516. 10.1136/adc.2008.142646.

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Abstract

Objective: Few studies have reported on nutritional recovery, survival and growth among severely malnourished children with HIV. This study explores nutritional recovery in HIV-infected and HIV-uninfected children during inpatient nutrition rehabilitation and 4 months of follow-up.Design: Prospective cohort study.Setting: Lilongwe district, Malawi.Main outcome measures: Weight gain, anthropometrics.Results: In our sample of 454 children with severe acute malnutrition (SAM), 17.4% (n = 79) of children were HIV infected. None of the children were on antiretroviral therapy upon admission. Among the HIV-infected children, 35.4% (28/79) died, compared with 10.4% (39/375) in HIV-uninfected children (p<0.001). All children who survived achieved nutritional recovery (>85% weight for height and no oedema), regardless of HIV status. HIV-infected children had similar weight gain to HIV-uninfected children (8.9 vs 8.0 g/kg/d, not significant (NS)). Mean increases in z-scores for both subscapular (2.72 vs 2.69, NS) and triceps (1.26 vs 1.48, NS) skinfolds were similar between HIV-infected and HIV-uninfected children, respectively, during nutrition rehabilitation. 362 children were followed for 4 months, at which time mean weight for height z-score was similar in HIV-infected and HIV-uninfected children (20.85 vs 20.64, NS).Conclusions: HIV-infected children with SAM have higher mortality rates than HIV-uninfected children. Among those who survive, however, nutritional recovery is similar in HIV-infected and HIV-uninfected children.

Type:Article
Title:Nutritional recovery in HIV-infected and HIV-uninfected children with severe acute malnutrition
DOI:10.1136/adc.2008.142646
Keywords:MALNOURISHED CHILDREN, MALAWIAN CHILDREN, MORTALITY, MANAGEMENT, IMPACT, FOOD
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Child Health

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