Micronutrient supplementation for children with HIV infection

Area of Science:

• Pediatrics
• Infectious Diseases
• Nutrition Science

Background:

• Micronutrient deficiencies exacerbate HIV disease in children, particularly in resource-limited settings.
• Previous reviews indicated vitamin A and zinc are beneficial and safe for children with HIV.
• This review updates evidence on micronutrient supplementation for children living with HIV.

Purpose of the Study:

• To evaluate the effectiveness and safety of micronutrient supplements in reducing mortality and morbidity in children with HIV infection.
• To synthesize findings from randomized controlled trials on micronutrient supplementation in pediatric HIV.

Main Methods:

• Searched CENTRAL, EMBASE, and PubMed databases for randomized controlled trials (RCTs) of micronutrient supplements.
• Included RCTs comparing micronutrient supplements with placebo or no treatment, focusing on mortality, morbidity, and hospitalizations.
• Conducted random effects meta-analysis for dichotomous and continuous data.

Main Results:

• Vitamin A supplementation halved all-cause mortality in African children with HIV and improved short-term growth.
• Zinc supplements reduced diarrheal morbidity without adverse effects on disease progression.
• Multiple micronutrient supplements showed clinical benefits in malnourished children, including reduced hospital admissions and improved appetite.

Conclusions:

• Vitamin A supplementation is beneficial and safe for children with HIV infection.
• Zinc is safe and offers benefits for diarrheal morbidity in children with HIV.
• Multiple micronutrient supplements provide clinical benefits for malnourished children with HIV; further research on optimal use is needed.