Nutrition and HIV/AIDS: A Training Manual - Linkages Project

Progressive Stuntingin HIV-Positive Children• Perinatal HIV infection associatedwith early and progressive growthfailure• More devastating nutritionimplications of HIV for childrenbecause of added growth anddevelopment demandsEtiology of Growth Failurein HIV-Infected Children• Significant weight and lengthdifferences by 2 nd year, evenexcluding early mortality (Move et al1996; Berhane et al 1997)• Preferential reduction in fat-freebody mass (Arpadi et al)Growth Failure IsComplex and Multifactorial• Reciprocal relation between HIV viral load and growth• Favorable effect of suppression of viral load on growth(especially weight)• Positive effect of protease inhibitors on growth and leanbody mass• Underlying morbidity (disease activity)• Simple starvation (inability to consume adequateenergy and nutrients), including malabsorption andgastrointestinal disease• Negative effect on fat-free mass of metabolic andendocrine alterations associated with stress andtrauma• Micronutrient deficiencies (vitamin A, zinc, selenium)Effects of HIV/AIDS on NutritionInflammatoryresponseMalabsorptionAdversedrugeffectsIncreasedenergyrequirementsEffects of HIVon nutritionFrequentdiarrheaepisodesIncreasednutrientrequirementRecurrentsecondaryinfectionsAnorexia,oral pathologyConsequencesof Growth Failurein HIV-Infected ChildrenThe severity of growth failure amongHIV-positive children is associated withreduced survival.