Skip to main content

Advertisement

SpringerLink
Log in

Effect of Nutrition Supplementation in Children Living with HIV at ART Centre

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To assess the benefits of nutrition supplementation in children living with HIV (CLHIV).

Methods

A prospective observational study was carried out at antiretroviral therapy (ART)/pediatric centre of excellence (PCOE), Niloufer hospital for a period of one year in CLHIV (N = 164) aged 1 to 18 y referred to ART/PCOE. Nutrition supplementation was given in the form of Ready to Use Food (About 350 kcal and 12 g of protein per day) supplementation to assess improvement in Height for age Z (HAZ), Weight for Age Z (WAZ), Weight for Height Z (WHZ) and Body Mass Index for age Z (BMIZ) scores over a period of one year.

Results

At baseline, 65.5 % and 57.5 % of children below and above 5 y respectively were stunted. 24.1 % and 45.3 % children below and above 5 y respectively were wasted/thin (as assessed by BMI for age). Mean BMIZ score significantly improved in both the age groups (0.96 Z score, P < 0.001) in below and above 5 (0.37 Z score, P < 0.001) respectively at the end of 12 mo. Mean HAZ score also significantly improved in children above 5 y (0.09 Z score, P < 0.05) with non-significant improvement below 5 y (0.14 Z score, P < 0.57) by the end of 12 mo.

Conclusions

Nutrition supplementation over one year resulted in moderate improvement in the nutritional status of CLHIV. However, it is unclear, whether the improvement in nutritional status was due to regular visits to ART centre that may have resulted in better adherence to treatment or an additional benefit of nutrition intervention. This warrants a well-designed randomized controlled trial to examine the benefits of nutrition supplementation in CLHIV attending ART centre.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

AOR:

Adjusted Odd Ratio

AP Foods:

Andhra Pradesh Foods

ART:

Antiretroviral Therapy

ARV:

Antiretroviral

BMI:

Body Mass Index

BMIZ:

Body Mass Index for Age Z Score

CD4:

Cluster of Differentiation-4

CED:

Chronic Energy Deficiency

CLHA:

Children Living with HIV/AIDS

CLHIV:

Children Living with Human Immunodeficiency Virus

HAZ:

Height for Age Z Score

HIV:

Human Immunodeficiency Virus

NACO:

National Aids Control Organization

PCOE:

Pediatric Centre of Excellence

Pre-ART:

Pre Antiretroviral Therapy

RCT:

Randomized Controlled Trial

RPC:

Regional Pediatric Centre

RUTF:

Ready to Use Therapeutic Food

WAZ:

Weight for Age Z Score

WCD:

Women & Child Development

WHO:

World Health Organization

WHZ:

Weight for Height

References

  1. WHO. Key facts on HIV epidemic and progress in regions and countries in 2010. In: WHO. Available at: http://wwwwhoint/hiv/pub/progress_report2011/regional_facts/en/index1html. Accessed on 27 Apr 2014.

  2. National Family Health Survey (NFHS-3). Mumbai: International Institute for Population Sciences; 2007.

  3. Babameto G, Kotler DP. Malnutrition in HIV infection. Gastroenterol Clin North Am. 1997;26:393–415.

    Article  CAS  PubMed  Google Scholar 

  4. Macallan DC, Noble C, Baldwin C, et al. Energy expenditure and wasting in human immunodeficiency virus infection. N Engl J Med. 1995;333:83–8.

    Article  CAS  PubMed  Google Scholar 

  5. Rose AM, Hall CS, Martinez-Alier N. Aetiology and management of malnutrition in HIV-positive children. Arch Dis Child. 2014;30:33–48.

    Google Scholar 

  6. Stringer JSA, Zulu I, Levy J, et al. Rapid scale-up of antiretroviral therapy at primary care sites in Zambia: feasibility and early outcomes. JAMA. 2006;296:782–93.

    Article  CAS  PubMed  Google Scholar 

  7. Zachariah R, Fitzgerald M, Massaquoi M, et al. Risk factors for high early mortality in patients on antiretroviral treatment in a rural district of Malawi. AIDS. 2006;20:2355–60.

    Article  PubMed  Google Scholar 

  8. World Health Organization. Nutrition requirements for people living with HIV/AIDS: Report of a technical consultation. Geneva: WHO; 2003.

    Google Scholar 

  9. WHO. Description. Available at: http://www.who.int/nutgrowthdb/about/introduction/en/index5.html. Accessed on 21 Apr 2015.

  10. Mda S, van Raaij JMA, MacIntyre UE, de Villiers FPR, Kok FJ. Duration of hospitalization and appetite of HIV-infected South African children. Matern Child Nutr. 2011;7:175–87.

    Article  PubMed  Google Scholar 

  11. Kosmiski L Energy expenditure in HIV infection. Am J Clin Nutr. 2011;94:1677S–82.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Villamor E, Mbise R, Spiegelman D, et al. Vitamin A supplements ameliorate the adverse effect of HIV-1, malaria, and diarrheal infections on child growth. Pediatrics. 2002;109:E6.

  13. Coutsoudis A, Bobat RA, Coovadia HM, Kuhn L, Tsai WY, Stein ZA. The effects of vitamin A supplementation on the morbidity of children born to HIV-infected women. Am J Public Health. 1995;85:1076–81.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Srinivasan MG, Ndeezi G, Mboijana CK, et al. Zinc adjunct therapy reduces case fatality in severe childhood pneumonia: a randomized double blind placebo-controlled trial. BMC Med. 2012;10:14.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Irlam JH, Siegfried N, Visser ME, Rollins NC. Micronutrient supplementation for children with HIV infection. Cochrane Database Syst Rev. 2013;10:CD010666.

  16. Sunguya BF, Poudel KC, Mlunde LB, et al. Ready to Use Therapeutic Foods (RUTF) improves undernutrition among ART-treated, HIV-positive children in Dar es Salaam. Tanzania Nutr J. 2012;11:60.

    PubMed  Google Scholar 

  17. Bhutta ZA, Ahmed T, Black RE, et al. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008;371:417–40.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank women & child development (WCD) and Andhra Pradesh (AP) Foods for providing nutritional supplements throughout the study period. They thank Superintendent, Niloufer hospital for the support and encouragement for the study. They thank Dr. Sujatha, Ex Medical officer for provided medical services. They thank all the staff members of antiretroviral therapy (ART)/pediatric centre of excellence (PCOE) for the smooth functioning of the project. Lastly, they would like to sincerely thank the patients attending the PCOE for their continued trust in the treatment and care provided at the centre.

Contributions

HST and GSG: Involved in study design; RSM, BK and SPK: Analyzed and interpreted data; HST and SPK: Wrote the first draft; RSM and BK: Helped in editing the paper. All the authors approved the final manuscript. HST will act as guarantor for this paper.

Conflict of Interest

None.

Source of Funding

None.

Author information

Authors and Affiliations

  1. Pediatric Centre of Excellence, Niloufer Hospital, Hyderabad, 500 004, India

    Himabindu Singh Thakur, Geetha Srivalliswari Gottapu & Sai Prasad Kadali

  2. Clinical Division, National Institute of Nutrition, Hyderabad, India

    Bharati Kulkarni & Raja Sriswan Mamidi

Authors
  1. Himabindu Singh Thakur
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Geetha Srivalliswari Gottapu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sai Prasad Kadali
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bharati Kulkarni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Raja Sriswan Mamidi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Himabindu Singh Thakur.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thakur, H.S., Gottapu, G.S., Kadali, S.P. et al. Effect of Nutrition Supplementation in Children Living with HIV at ART Centre. Indian J Pediatr 83, 232–237 (2016). https://doi.org/10.1007/s12098-015-1873-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-015-1873-5

Keywords

Search

Navigation