Nutritional recovery in HIV-infected and HIV-uninfected children with severe acute malnutrition.
OBJECTIVE
Few studies have reported on nutritional recovery, survival and growth among severely malnourished children with HIV. This study explores nutritional recovery in HIV-infected and HIV-uninfected children during inpatient nutrition rehabilitation and 4 months of follow-up.


METHODS
Prospective cohort study.


METHODS
Lilongwe district, Malawi.


METHODS
Weight gain, anthropometrics.


RESULTS
In our sample of 454 children with severe acute malnutrition (SAM), 17.4% (n = 79) of children were HIV infected. None of the children were on antiretroviral therapy upon admission. Among the HIV-infected children, 35.4% (28/79) died, compared with 10.4% (39/375) in HIV-uninfected children (p<0.001). All children who survived achieved nutritional recovery (>85% weight for height and no oedema), regardless of HIV status. HIV-infected children had similar weight gain to HIV-uninfected children (8.9 vs 8.0 g/kg/d, not significant (NS)). Mean increases in z-scores for both subscapular (2.72 vs 2.69, NS) and triceps (1.26 vs 1.48, NS) skinfolds were similar between HIV-infected and HIV-uninfected children, respectively, during nutrition rehabilitation. 362 children were followed for 4 months, at which time mean weight for height z-score was similar in HIV-infected and HIV-uninfected children (-0.85 vs -0.64, NS).


CONCLUSIONS
HIV-infected children with SAM have higher mortality rates than HIV-uninfected children. Among those who survive, however, nutritional recovery is similar in HIV-infected and HIV-uninfected children.
Fergusson
P
P
Liverpool School of Tropical Medicine, Disease Control Group, Pembroke Place, Liverpool L3 5QA, UK. pamela.fergusson@gmail.com
Chinkhumba
J
J
Grijalva-Eternod
C
C
Banda
T
T
Mkangama
C
C
Tomkins
A
A
D000886:Anthropometry; D015362:Child Nutrition Disorders / Q000401:mortality / Q000534:rehabilitation; D002675:Child, Preschool; D015658:HIV Infections / Q000401:mortality*; D015497:HIV-1; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000401:mortality / Q000534:rehabilitation; D008295:Malawi / Q000453:epidemiology; D044342:Malnutrition / Q000401:mortality* / Q000534:rehabilitation*; D009752:Nutritional Status; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015430:Weight Gain