title: Aetiology and management of malnutrition in HIV-positive children.
abstract: Worldwide, more than 3 million children are infected with HIV and, without treatment, mortality among these children is extremely high. Both acute and chronic malnutrition are major problems for HIV-positive children living in resource-limited settings. Malnutrition on a background of HIV represents a separate clinical entity, with unique medical and social aetiological factors. Children with HIV have a higher daily calorie requirement than HIV-negative peers and also a higher requirement for micronutrients; furthermore, coinfection and chronic diarrhoea due to HIV enteropathy play a major role in HIV-associated malnutrition. Contributory factors include late presentation to medical services, unavailability of antiretroviral therapy, other issues surrounding healthcare provision and food insecurity in HIV-positive households. Treatment protocols for malnutrition have been greatly improved, yet there remains a discrepancy in mortality between HIV-positive and HIV-negative children. In this review, the aetiology, prevention and treatment of malnutrition in HIV-positive children are examined, with particular focus on resource-limited settings where this problem is most prevalent.
authors.affiliation: Department of Genetics, UCL Institute of Ophthalmology, London, UK UCL Medical School, London, UK.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Rose
authors.affiliation: UCL Medical School, London, UK UCL Institute of Global Health, London, UK.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Hall
authors.affiliation: Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, King's Health Partners, London, UK.
authors.forename: Nuria
authors.initials: N
authors.lastname: Martinez-Alier
mesh_terms: D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D044342:Malnutrition / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy*; D009752:Nutritional Status; D012307:Risk Factors
keywords: HIV; Nutrition; Tropical Paediatrics