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

Growth Failure Associated withIncreased Risk of DeathMortality Odds Ratio5432104.873.392.74-1.5 -1 -0.75Average WAZ in First Year of LifeHIV-infected infants with weight-for-age below –1.5 Z-scoreshave five times higher risk of dying before 25 months thannon-infected children (Berhane et al 1997)Other Factors Associatedwith HIV Infection in Children• Retarded cognitive development andfunctional deficits (e.g., delayed sexualdevelopment among boys)• Body composition alterations, withpreferential decreases of the lean bodymass (or fat-free mass)Goals ofNutritional Care and SupportNutritional Care and Supportof Young ChildrenInfected with HIV• Provide essential co-therapy to maximize medicalmanagement of HIV• Prevent wasting and specific nutrient deficiencies• Build stores of essential nutrients to boostimmunity to resist infections and speed recovery• Prevent food-borne illnesses and their impact• Support HIV therapy by improving the effectivenessof drug treatment and reducing cost to family andcare-giving institutionFactors to Consider inPlanning Nutritional Support• Nutritional status• Nutrient requirements• Food-intake-relatedproblems• Food preferences anddislikes• Food allergies andintolerance• Stage of HIV infection• Weight loss and changes• Medical problems andtreatment, includingmedications• Socioeconomic status• Family support• Nutrition knowledge ofcaretakerEssential Components ofNutritional Support1. Good obstetric care and maternal nutrition to preventlow birth weight and prematurity2. Frequent nutritional monitoring to recognize earlygrowth faltering and other nutritional problems andinform interventions3. Increased food intake and diversification, includingperiodic supplementation (especially with vitamin A)4. Promotion of proper food hygiene and handling andperiodic deworming5. Prompt treatment of infections that cause weight loss6. Use of antiretrovirals where available and affordable