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9 - Growth, nutrition, and metabolism

Published online by Cambridge University Press:  23 December 2009

By
Caroline J. Chantry  and
Jack Moye Jr.
Edited by
Steven L. Zeichner  and
Jennifer S. Read
Caroline J. Chantry
Affiliation:
Department of Clinical Pediatrics, University of California Davis Medical Center, Sacramento, CA
Jack Moye Jr.
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 Institutes of Health, Bethesda, Maryland
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Summary

In recent years, growth, nutrition and metabolism of HIV-infected children have received 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.

Definitions: malnutrition, growth failure

Pediatric HIV disease may 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
Handbook of Pediatric HIV Care , pp. 273 - 308
Publisher: Cambridge University Press
Print publication year: 2006

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  • Growth, nutrition, and metabolism
    • By Caroline J. Chantry, Department of Clinical Pediatrics, University of California Davis Medical Center, Sacramento, CA, Jack Moye, Jr., 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
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.011
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  • Growth, nutrition, and metabolism
    • By Caroline J. Chantry, Department of Clinical Pediatrics, University of California Davis Medical Center, Sacramento, CA, Jack Moye, Jr., 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
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.011
Available formats
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Save book to Google Drive

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  • Growth, nutrition, and metabolism
    • By Caroline J. Chantry, Department of Clinical Pediatrics, University of California Davis Medical Center, Sacramento, CA, Jack Moye, Jr., 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
  • Book: Handbook of Pediatric HIV Care
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544781.011
Available formats
×