Nutritional Care of the Child with Human Immunodeficiency Virus Infection in the United States

• Type of Material: Article
• Authors: Jamila Sheikh, Ponce Family and Youth Clinic; Bridget A. Wynn, Emory University; Rana Chakraborty, Emory University
• Language: English
• Date: 2015-05-08
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2015 Elsevier Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1016/B978-0-12-800769-3.00009-3
• Title of Journal or Parent Work: Food, Nutrition and Lifestyle with Antiretroviral Drugs
• Volume: 2015
• Start Page: 135
• End Page: 155
• Grant/Funding Information: None declared
• Keywords: enteropathogens; HIV; children; wasting; combination antiretroviral therapy; micronutrients
• Research Categories: Health Sciences, Nutrition; Health Sciences, Human Development; Health Sciences, Health Care Management; Health Sciences, Public Health

Abstract

In well-resourced settings, early infant diagnosis and administration of life-saving antiretrovirals (ARVs) have significantly improved clinical outcomes in pediatric human immunodeficiency virus (HIV) infection. The dramatic increase in survival rates is associated with enhancements in overall quality of life, which reflect a multidisciplinary, holistic approach to care. Current optimism starkly contrasts with the outlook and prognosis two decades ago, when failure to thrive and wasting syndrome from uncontrolled pediatric HIV infection resulted from poor oral intake, malabsorption, chronic diarrhea, and a persistently catabolic state. The tenets of care developed from that era still hold true in that all infants, children, and adolescents with HIV require comprehensive nutritional services in addition to effective combination antiretroviral therapy (cART). This chapter will review the principles of nutrition in the pre- and post-cART eras and discuss the etiologic factors associated with malnutrition, with an emphasis on interventions that have favorably impacted the growth and body composition of infants, children and adolescents with HIV.