title: A Systematic Review of Nutritional Supplementation in HIV-Infected Children in Resource-Limited Settings.
abstract: BACKGROUND
  In resource-limited settings, malnutrition is the major cause of death in young children, but the precise benefits of nutritional supplementation for HIV-infected children are not well understood.
  
  
  METHODS
  Two researchers reviewed studies conducted in low- or middle-income countries that involved macro- and micronutrient supplementation in HIV-infected individuals ≤18 years.
  
  
  RESULTS
  Fifteen studies focused on micronutrients, including vitamin A, zinc, multivitamins, and multiple-micronutrient supplementation. The 8 macronutrient studies focused on ready-to-use foods (4 studies), spirulina, whey protein, general food rations, and F75 and F100 starter formulas. Vitamin A was associated with improved mortality rates, ranging from 28% to 63%. Multiple-micronutrient supplementations were not associated with improvement of measured health outcomes. Ready-to-use foods were associated with improvement in certain anthropometrics.
  
  
  CONCLUSIONS
  Periodic vitamin A supplementation is associated with reduced mortality. Macronutrient supplementation is linked to improved anthropometrics. More research is needed to determine how nutritional supplementation benefits this particularly vulnerable population.
authors.affiliation: Department of Pediatrics, Children's Health Services Research, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Megan S
authors.initials: MS
authors.lastname: McHenry
authors.affiliation: Department of Pediatrics, Children's Health Services Research, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Avika
authors.initials: A
authors.lastname: Dixit
authors.affiliation: Department of Pediatrics, Children's Health Services Research, Indiana University School of Medicine, Indianapolis, IN, USA USAID-Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya rvreeman@iupui.edu.
authors.forename: Rachel C
authors.initials: RC
authors.lastname: Vreeman
mesh_terms: D000293:Adolescent; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003906:Developing Countries; D019587:Dietary Supplements; D015658:HIV Infections / Q000178:diet therapy*; D006801:Humans; D007223:Infant; D018977:Micronutrients / Q000008:administration & dosage*; D011203:Poverty
chemical_list: D018977:Micronutrients
keywords: AIDS; HIV; children; clinical outcomes; nutrition; nutritional supplementation