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The effect of nutritional support on weight gain of HIV-infected children with prolonged diarrhoea

N C Rollins1, J van den Broeck, G Kindra

  • 1Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Congella 4013, South Africa. rollins@ukzn.ac.za

Acta Paediatrica (Oslo, Norway : 1992)
|December 26, 2006
PubMed

Insights

Enhanced nutrition significantly improved weight gain in HIV-infected children with prolonged diarrhea. However, it did not improve immune markers or survival rates in this vulnerable population.

Area of Science:

  • Pediatric Infectious Diseases
  • Nutritional Science
  • Immunology

Background:

  • Prolonged diarrhea is a common and serious complication in children with advanced Human Immunodeficiency Virus (HIV) infection.
  • Malnutrition and impaired growth are significant challenges in pediatric HIV management, exacerbating disease progression.
  • Effective nutritional interventions are crucial for improving outcomes in immunocompromised children.

Purpose of the Study:

  • To evaluate the impact of enhanced calorie and protein nutrition on growth and immune status in HIV-infected children experiencing prolonged diarrhea.
  • To determine if intensified nutritional support can mitigate the adverse effects of diarrhea on weight gain and immune cell counts.

Main Methods:

  • A randomized controlled trial involving 169 HIV-infected children (6-36 months) with diarrhea lasting at least 7 days.
  • Participants were assigned to either standard nutritional support or an enhanced diet initiated during hospitalization and continued post-discharge.
  • Key outcome measures included weight changes at 8, 14, and 26 weeks, and changes in plasma HIV-RNA and CD4 cell counts at 8 and 26 weeks.

Main Results:

  • Children receiving enhanced nutrition demonstrated significantly greater weight gain between enrollment and 8 weeks compared to the standard support group (p < 0.001).
  • While initial weight velocity improved with enhanced nutrition, median weight velocity became similar in both groups after 8 weeks.
  • No significant differences were observed in the change of median CD4 cell counts between the two groups.
  • The 26-week mortality rate was high and comparable in both the standard (22%) and enhanced (29%) nutrition groups.

Conclusions:

  • Enhanced nutritional support leads to significant and sustained weight gain in HIV-infected children with prolonged diarrhea.
  • Despite improvements in weight, enhanced nutrition did not improve CD4 cell counts or reduce mortality in this cohort.
  • Integrated nutrition interventions are vital for managing HIV-infected children, but further strategies are needed to improve immune function and survival.
Abstract

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