Assessment of Nutritional Status of HIV Positive Children in Antiretroviral Therapy Center: A Study From Central India

Background and Objectives: HIV-infected children are undernourished; an improvement in their nutritional status may significantly decrease their morbidity. Thus, determining the etiology and temporal course of malnutrition in children with HIV infection will be important for early intervention and development of refeeding regimens. This cross-sectional study describes the nutritional status and the variables affecting it, among the children made vulnerable by HIV/AIDS, (1) To assess the nutritional status of the HIV positive children, (2) to study the variables affecting the nutritional status of HIV positive children. Methodology: The study involved 84 HIV-positive children of 18 months-18 years age group in the antiretroviral therapy center of J.A Group of Hospital, G.R Medical College, Gwalior, Madhya Pradesh. Anthropometric measurements, birth and maternal characteristics, socio-economic and immunization profile, past illness were recorded. Z-scores were generated using WHO standards as indicators of nutritional status, and variables were assessed by the suitable statistical test. Results: Prevalence of undernutrition is very high particularly moderate and severe stunting (76.19%), moderate and severe underweight (71.42%), and moderate and severe wasting (38.09%) in <5 years HIV-positive children. While low height-for-age was observed in 60.31%, low weight-for-age in 34.92%, and low body mass index-for-age was recorded in 20.63%, in 6-18 years age group. Besides HIV status, other significant determinants of nutritional outcomes include child factors, birth-related factors, maternal level factors, socio-economic and past history of illness. Conclusion: HIV is an independent and non-modifiable risk factor for poor nutritional outcomes in those who are already infected, but an improvement in their nutritional status may significantly decrease their morbidity. Early pediatric HIV testing of exposed or at risk children, followed by appropriate health care for infected children with the integration of other child survival interventions like immunization, community participation may improve their nutritional status and survival.