Nutritional support whilst on HIV treatment
Malnutrition is common in children living with HIV in low and middle-income countries, and is a major cause of death.36 Ideally, children living with HIV who are asymptomatic need to consume 10% more calories than other children of their age and sex. Children who are symptomatic, or recovering from acute infections, need to consume 20-30% more calories than other children.37
If a child is suffering from malnutrition, it is recommended that they receive treatment to stabilise their condition before HAART is started. In poorer areas, however, this is not always possible. Even where it is possible to treat malnutrition, recovery from this condition is likely to be slow and limited in HIV-positive children. If a child has not been cured of malnutrition after six to eight weeks of special feeding or appropriate treatment, it may be decided that HAART should be started despite their condition.
In the opposite situation, where a child experiences rapid weight gain as a result of ARVs, nutrition also needs to be monitored carefully. As a child’s weight changes, so does the recommended dosage of ARVs that they require, so drug doses need to be constantly reviewed.3
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