Study on prevalence of malnutrition and related risk factors among human immunodeficiency virus-infected children in China

Objective To investigate the prevalence of malnutrition in human immunodeficiency virus (HIV)-infected children in China, and to explore and analyze the factors associated with malnutrition. Methods A cross-sectional study was conducted by the antiretroviral treatment database of children. HIV-infected children aged between 0-15 years old who initiated antiretroviral treatment were collected between January 1st, 2010 and December 31st, 2014. Z-score of height and weight were calculated by WHO Anthro (plus) software. Univariate and multivariate Logistic model analyses were performed to determine the factors associated with acute/chronic/mixed malnutrition. Results Baseline data of the 3 138 HIV-infected children showed that 1 645 patients (52.42%) had malnutrition before antiretroviral treatment, with acute, chronic and mixed malnutrition of 8.76% (275), 39.77%(1 248) and 3.89% (122), respectively according to the type of malnutrition. Multivariate analysis showed that baseline CD4+ cell count<200 cells/μL was the risk factor associated with acute malnutrition (aOR=2.27, 95%CI: 1.68-3.06); rural settings (aOR=1.30, 95%CI: 1.11-1.53), baseline CD4+ cell count<200 cells/μL (aOR=1.98, 95%CI: 1.65-2.38), baseline CD4+ cell count between 200 to 350 cells/μL (aOR=1.38, 95%CI: 1.13-1.69) and having AIDS-related diseases (aOR=1.34, 95%CI: 1.13-1.59) were risk factors associated with chronic malnutrition; and age of 11-15 years (aOR=2.38, 95%CI: 1.46-3.88), baseline CD4+ cell count<200 cells/μL (aOR=4.99, 95%CI: 3.04-8.21) and having AIDS-related diseases (aOR=2.45, 95%CI: 1.65-3.66) were risk factors associated with mixed malnutrition. Conclusions The prevalence of malnutrition in untreated HIV-infected children remains high. All three types of malnutrition are associated with immunodeficiency. Early diagnosis and early treatment should be improved in HIV-infected children through antiviral therapy to reduce the destruction of HIV to immune system. At the same time, intensified monitoring of the nutritional status and nourishing undernourished children should be strengthened to reduce the prevalence of malnutrition. Key words: Human immunodeficiency virus; Malnutrition; Children