Prevalence and predictors of undernutrition in HIV-infected children on antiretroviral therapy in Abakaliki, Southeast Nigeria

Background: The introduction of antiretroviral therapy (ART) to HIV medicine has dramatically improved the quality of care of HIV-infected children, translating to better nutritional status and general well-being. However, many HIV-infected children especially in sub-Saharan Africa, despite being on ART are malnourished. Objective: The study was done to determine the prevalence and predictors of undernutrition among HIV-infected children on ART in Abakaliki. Materials and Methods: It was a case–control study with a sample size of 220 (110 HIV infected and 110 HIV negative children as controls) aged 2–17 years. Anthropometric indicators expressed in Z scores were used to define malnutrition: Height for age (stunting) and weight for age (underweight) and weight for height (thinness). A structured questionnaire was used to obtain socio-demographic characteristics and drug adherence. Results: The prevalence rates of underweight and stunting were 24.5% and 20.0% in HIV-infected children as against the prevalence rates of 10.0% and 6.4% for underweight and stunting, respectively, found in HIV negative children. These prevalence rates were statistically significant (P = 0.002 and P = 0.001, respectively). Occupation of caregivers (P = 0.000, P = 0.000), drug adherence (P = 0.001, P = 0.000), and WHO clinical stages of disease (P = 0.002, P = 0.000) were statistically significant predicted the presence of underweight and stunting, respectively, in HIV-infected children on ART. Conclusion: The prevalence of undernutrition is high among children on ART. Nutritional support as well as strengthening adherence to ART is strongly advocated as part of routine care in HIV-infected children on ART.