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Nutrition linked to improved outcomes in children with HIV
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After 1 year on antiretroviral therapy, children with HIV who participated in a nutritional supplementation program had better anthropometric parameters and lower viral loads, researchers said.
Karin Nielsen-Saines, MD, MPH, of the department of pediatrics, David Geffen School of Medicine at the University of California Los Angeles, and colleagues reported results on more than 2,000 children aged younger than 15 years who were seen at 17 centers in Mozambique, Malawi and Guinea between 2005 and 2008. More than 60% of these children were aged 5 years and younger.
Karin Nielsen-Saines
The researchers reported that although children with HIV who were seen at the centers were commonly malnourished and had stunted growth parameters, these markers improved with antiretroviral therapy.
“Kaplan Meier estimates demonstrated survival in-care rates of 88.5%, 84.1% and 83% at one, two and three years following initiation of combination ART, with an overall mortality of 6.9 per 100 person/years,” the researchers wrote. “We attribute our positive findings, particularly low mortality, to a successful nutritional supplementation and rehabilitation program, which contributed to the improved growth and development of children seen at our centers.”
The researchers added that of the 1,226 children who completed one year of therapy, two-thirds had undetectable viral loads at follow-up.
The study is part of the DREAM program, which is a country public health initiative that provides a holistic approach to HIV medicine through a free-of-charge medical care package, including the provision of combination ART, continued laboratory evaluations and monitoring, management of opportunistic infections, nutritional evaluation and supplementation, education and social support, and voluntary counseling and HIV testing.
Karin Nielsen-Saines, MD, MPH, can be reached at Knielsen@mednet.ucla.edu.
Disclosure: Nielsen-Saines reports no relevant financial disclosures.
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