Children, AIDS and nutrition: an experience from Chiang Mai, Thailand

This paper on the experience in Chiang Mai, Thailand, highlighted some of the features of the nature of the paediatric human immunodeficiency virus infection. In Chiang Mai, the incidence of positive HIV tests in pregnant women was 1- 2% and the perinatal transmission rate was approximately 40%. One particular characteristic of HIV infection in Chiang Mai is the association with Penicillium marneffei skin infection. Common clinical features of HIV-infected children are similar to protein energy malnutrition. Once malnutrition occurs in HIV-infected children, the disease deteriorates and the prognosis is worsened. In order to reduce morbidity and mortality in Thai HIV-infected children, early and aggressive nutrition support seems to be a crucial factor in their management. However, Thailand is in a difficult situation as the country is already trying to eradicate malnutrition in children, pregnant and lactating women and is now faced with the added burden of dealing with the secondary malnutrition resulting from the HIV/AIDS epidemic. A preliminary study of 24 HIV positive children (12 boys, 12 girls) aged 1-26 months admitted to the Chiang Mai University Hospital was conducted. Eighty-eight percent of the subjects were malnourished, and a quarter had percent weight for age less than or equal to 60% (third degree protein energy malnutrition). Five (21%) subjects had birthweights less than or equal to 2,500g. To date, over 100 cases of paediatric HIV have been admitted to the Chiang Mai University Hospital. Nutrition plays and important role in HIV infection. Further research is urgently needed in various areas of nutrition and paediatric HIV/AIDS to improve clinical care. A case history of paediatric AIDS was also shown.