Challenges of malnutrition care among HIV-infected children on antiretroviral treatment in Africa

Med Mal Infect. 2015 May;45(5):149-56. doi: 10.1016/j.medmal.2015.03.002. Epub 2015 Apr 7.

Abstract

More than 90% of the estimated 3.2 million children with HIV worldwide, at the end of 2013, were living in sub-Saharan Africa. The management of these children was still difficult in 2014 despite the progress in access to antiretroviral drugs. A great number of HIV-infected children are not diagnosed at 6 weeks and start antiretroviral treatment late, at an advanced stage of HIV disease complicated by other comorbidities such as malnutrition. Malnutrition is a major problem in the sub-Saharan Africa global population; it is an additional burden for HIV-infected children because they do not respond as well as non-infected children to the usual nutritional care. HIV infection and malnutrition interact, creating a vicious circle. It is important to understand the relationship between these 2 conditions and the effect of antiretroviral treatment on this circle to taking them into account for an optimal management of pediatric HIV. An improved monitoring of growth during follow-up and the introduction of a nutritional support among HIV-infected children, especially at antiretroviral treatment initiation, are important factors that could improve response to antiretroviral treatment and optimize the management of pediatric HIV in resource-limited countries.

Keywords: Africa; Afrique; Child; Enfant; HIV; Malnutrition; Retard de croissance; Stunting; VIH.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • AIDS-Related Opportunistic Infections / epidemiology
  • AIDS-Related Opportunistic Infections / immunology
  • AIDS-Related Opportunistic Infections / prevention & control
  • Adolescent
  • Africa South of the Sahara / epidemiology
  • Anemia / etiology
  • Anthropometry
  • Anti-HIV Agents / therapeutic use*
  • Child
  • Child Nutrition Disorders / epidemiology*
  • Child Nutrition Disorders / immunology
  • Child Nutrition Disorders / therapy
  • Child, Preschool
  • Comorbidity
  • Developing Countries
  • Dietary Supplements
  • Disease Progression
  • Female
  • Growth Disorders / diagnosis
  • Growth Disorders / etiology
  • Growth Disorders / prevention & control
  • HIV Infections / congenital
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Wasting Syndrome / epidemiology
  • HIV Wasting Syndrome / immunology
  • Health Services Needs and Demand
  • Humans
  • Immunocompromised Host
  • Infant
  • Infant Nutrition Disorders / epidemiology*
  • Infant Nutrition Disorders / immunology
  • Infant Nutrition Disorders / therapy
  • Infant, Newborn
  • Male
  • Nutritional Status
  • Nutritional Support
  • Prevalence
  • Risk

Substances

  • Anti-HIV Agents