Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- 7 Diagnosis of HIV-1 infection in children
- 8 Prevention of mother-to-child transmission of HIV
- 9 Routine pediatric care
- 10 Immunizations
- 11 Prevention of opportunistic infections and other infectious complications of HIV in children
- 12 Emergency evaluation and care
- 13 Adherence to antiretroviral therapy in children and youth
- 14 Adolescents and HIV
- 15 Adolescent reproductive health and HIV
- 16 Growth, nutrition, and metabolism
- 17 Neurobehavioral function and assessment of children and adolescents with HIV-1 infection
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
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
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- 7 Diagnosis of HIV-1 infection in children
- 8 Prevention of mother-to-child transmission of HIV
- 9 Routine pediatric care
- 10 Immunizations
- 11 Prevention of opportunistic infections and other infectious complications of HIV in children
- 12 Emergency evaluation and care
- 13 Adherence to antiretroviral therapy in children and youth
- 14 Adolescents and HIV
- 15 Adolescent reproductive health and HIV
- 16 Growth, nutrition, and metabolism
- 17 Neurobehavioral function and assessment of children and adolescents with HIV-1 infection
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
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.
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- Information
- Textbook of Pediatric HIV Care , pp. 244 - 268Publisher: Cambridge University PressPrint publication year: 2005
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