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16 - Growth, nutrition, and metabolism

from Part II - General issues in the care of pediatric HIV patients

Published online by Cambridge University Press:  03 February 2010

By
Caroline J. Chantry  and
Jack Moye
Edited by
Steven L. Zeichner  and
Jennifer S. Read
Caroline J. Chantry
Affiliation:
Assistant Professor of Clinical Pediatrics, University of California Davis Medical Center, Sacramento, CA
Jack Moye
Affiliation:
Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, NIH, Bethesda, MD
Steven L. Zeichner
Affiliation:
National Cancer Institute, Bethesda, Maryland
Jennifer S. Read
Affiliation:
National Cancer Institute, Bethesda, Maryland
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Summary

In recent years, growth, nutrition, and metabolism of HIV-infected children have been receiving increased attention for several reasons. It has been recognized for the past decade that HIV-infected children generally do not grow as well as their uninfected counterparts, but more recent evidence suggests that this is often true even in the face of adequate virologic control. Given also that growth is a predictor of survival, there has been closer scrutiny of nutritional and metabolic factors that can contribute to poor growth. Additionally, potentially serious metabolic complications of HIV infection and/or antiretroviral therapies overlap with nutritional aspects of the infection and have prompted attention to the pathophysiology of malnutrition in these children.

The current state of knowledge regarding the complex interrelationships of nutrition, HIV disease, antiretroviral therapy, and growth is reviewed in this chapter. Recommendations for nutritional monitoring and support are discussed, as are therapies for certain recognized causes of malnutrition in HIV-infected children. Briefly described are the complications and recommended treatments for fat redistribution, hyperlipidemia, insulin resistance, osteonecrosis, and mitochondrial toxicity. Finally, nutritional issues most germane to resource-poor settings are highlighted, as are areas in which further research is needed.

Definitions: malnutrition and growth failure

Pediatric HIV disease can lead to multiple nutritional deficiencies. Deficiencies of adequate macronutrients (protein or calories) and/or micronutrients (vitamins, minerals) to maintain optimal health status is referred to as undernutrition or, more commonly, malnutrition. Many definitions for growth failure or failure to thrive (FTT) exist.

Type
Chapter
Information
Textbook of Pediatric HIV Care , pp. 244 - 268
Publisher: Cambridge University Press
Print publication year: 2005

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  • Growth, nutrition, and metabolism
    • By Caroline J. Chantry, Assistant Professor of Clinical Pediatrics, University of California Davis Medical Center, Sacramento, CA, Jack Moye, Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, NIH, Bethesda, MD
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read, National Cancer Institute, Bethesda, Maryland
  • Book: Textbook of Pediatric HIV Care
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544798.019
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  • Growth, nutrition, and metabolism
    • By Caroline J. Chantry, Assistant Professor of Clinical Pediatrics, University of California Davis Medical Center, Sacramento, CA, Jack Moye, Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, NIH, Bethesda, MD
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read, National Cancer Institute, Bethesda, Maryland
  • Book: Textbook of Pediatric HIV Care
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544798.019
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Growth, nutrition, and metabolism
    • By Caroline J. Chantry, Assistant Professor of Clinical Pediatrics, University of California Davis Medical Center, Sacramento, CA, Jack Moye, Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, NIH, Bethesda, MD
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read, National Cancer Institute, Bethesda, Maryland
  • Book: Textbook of Pediatric HIV Care
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544798.019
Available formats
×