medigraphic.com
ISSN 0035-0052 (Print)

2001, Number 6

<< Back Next >>

Rev Mex Pediatr 2001; 68 (6)

Nutritional evaluation in children with the human immunodeficiency virus

Martínez-Rojano H, Gorbea RMC

Language: Spanish
References: 33
Page: 264-269
PDF size: 57.44 Kb.


ABSTRACT

Malnutrition associated with HIV infection is potentially reversible and should be evaluated and treated. Identification of the etiologic agent responsible for wasting is possible using diagnostic algorithms. The initial task is to detect the malnutrition it could be difficult as early changes often are subtle. Periodic assessment in helpful. The initial work up of malnutrition should include a thorough history and physical examination, with special attention to alterations in body weight and body shape, changes in appetite, eating habits, and functional status (including physical activity). Difficulties with chewing or swallowing should be addressed, including oral candidiasis, aphthous ulcers, gingivitis, poor dentition, leukoplakia, herpetic lesions, and oral Kaposi's sarcoma. Problems of chewing or swallowing should be addressed, including oral candidiasis, aphthous ulcers, gingivitis, leukoplakia, and herpetic lesions. A complaint of poor appetite with no detectable reason should be taken as a warning. Some infections, including Cytomegalovirus and Mycobacterium avium-intracellulare complex (MAC), may have a slowly progressive clinical course, with up to two months of poor appetite and weight loss prior to the development of specific symptoms and clinical diagnosis. For this reason, careful monitoring of body weight or body composition, as well as fever curves, could provide the earliest evidence of opportunistic infection.


REFERENCES

  1. Paton NI, Castello-Branco LR, Jennings G, Ortigao-de-Sampaio, et al. Impact of tuberculosis on the body composition of HIV-infected men in Brazil. J Acquir Immune Defic Syndr Hum Retrovirol 1997; 77: 795-815.

  2. Sharpstone DR, Ross HM, Gazzard BG. The metabolic response to opportunistic in AIDS. AIDS 1996; 10: 1377-84.

  3. Martínez-Rojano H. Manejo nutricional del paciente pediátrico infectado por el VIH/SIDA En: Zavala TI, Gorbea RM, editores. Manejo del paciente con VIH/SIDA México: Corporativo Intermédica, S.A. de C.V. 1999: 95-110.

  4. Grant AD, Djomand G, De Cock KM. Natural history and spectrum of disease in adults with HIV/AIDS in Africa. AIDS 1997; 11 (Suppl B): S43-54.

  5. Centers for Disease Control and Prevention. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Morb Mortal Wkly Rep 1992; 41 (RR-17): 1-19.

  6. Christeff N, Lortholary O, Casassus P, et al. Relationship between sex steroid hormone levels and CD4 lymphocytes in HIV infected men. Exp Clin Endocrinol Diabetes 1996; 104: 130-6.

  7. Wheeler DA, Gilbert CL, Launer CA, et al. Weight loss as a predictor of survival and disease progression in HIV infection. J AIDS 1998; 18: 80-5.

  8. Sharpstone D, Murray C, Ross H, Phelan M, Crane R, et al. The influence of nutritional and metabolic status on progression from asymptomatic HIV infection to AIDS-defining diagnosis. AIDS 1999; 13: 1221-1226.

  9. Beisel WR. Nutrition and immune function: overview. J Nutr 1996; 126: 2611S-15S.

  10. Harbige LS. Nutrition and immunity with emphasis on infection and autoimmune disease. Nutr Health 1996; 10: 285-312.

  11. Paton NI, Macallan DC, Jebb SA, et al. Longitudinal changes in body composition measured with a variety of methods in patients with AIDS. J Acquir Immune Defic Syndr 1997;14: 119-127.

  12. Kotler DP, Rosenbaum K, Wang J, Pierson RN. Studies of body composition and fat distribution in HIV-infected and control subjects. J Acquir Immune Defic Syndr Hum Retrovirol 1999; 20(3): 228-237.

  13. Gorbea-Robles MC, Flores HL, Torres GF, Fuchs VT, Martínez-Rojano H. Nutrition assessment in pediatric patients infected with the human immunodeficiency virus. Nutrition in Clinical Practice 1998; 13: 172-176.

  14. Nicholas S, Leung J, Fennoy I. Guidelines for nutritional support of HIV-infected children. J Pediatrics 1991; 119: 59S-62S.

  15. Nemechek PM, Polsky B, Gottlieb MS. Treatment guidelines for HIV-associated wasting. Mayo Clin Proc 2000; 75: 386-394.

  16. Fields-Gardner C, Thompson CA, Rhodes SS. A Clinical's Guide to Nutrition in HIV and AIDS. Chicago: American Dietetic Association; 1197: 48-53.

  17. Arpadi SM, Wang J, Cuff PA, et al. Application of bioimpedance analysis for estimating body composition in prepubertad children infected with the human immunodeficiency virus type-1. J Pediatr 1996; 129(5): 755-757.

  18. Engelson EE, Kotler DP, Tan YX, Wang J, Pierson RN, Heymsfield SB. Fat distribution in HIV-infected patients reporting truncal enlargement quantified by whole-body magnetic resonance imaging. Am J Clin Nutr 1999; 69(6): 1162-1169.

  19. Ott M, Fischer H, Polat H, et al. Bioelectrical impedance analysis as a predictor of survival in patients with human immunodeficiency virus infection. J Acquir Immune Defic Syndr Hum Retrovirol 1995; 9(1): 20-25.

  20. Sluys TE, van der Ende ME, Swart GR, et al. Body composition in patients with acquired immunodeficiency syndrome: a validation study of bioelectric impedance analysis. JPEN 1993; 17: 404-406.

  21. Ott M, Lambke B, Fischer H, et al. Early changes of body composition in human immunodeficiency virus-infected patients: tetrapolar body impedance analysis indicates significant malnutrition. Am J Clin Nutr 1993; 57(1): 15-19.

  22. Pencharz PB, Azcue M. Use of bioelectrical impedance analysis measurements in the clinical management of malnutrition. Am J Clin Nutr 1996; 64 (Suppl): 485s-8s.

  23. Kotler DP, Gaetz HP, Klein EB, Lange M, Klein EB, Holt PR. Enteropathy associated with the acquired immunodeficiency syndrome. Ann Intern Med 1984; 101(4): 421-428.

  24. Miller TL, Awnetwant EL, Evans SJ, et. Gastrostomy tube supplementation for HIV-infected children. Pediatric 1995; 96: 696-702.

  25. Miller TL, Orau EJ, Martin SR, Cooper ER, McIntosh K, Winter HS. Malnutrition and carbohydrate malabsorption in children with vertically transmitted human immunodeficiency virus-1 infection. Gastroenterology 1991; 100: 1296-1302.

  26. Yolken RH, Hart W, Oung I, Shiff C, Greenson J, Perman JA. Gastrointestinal dysfunction and disaccharide intolerance in children infected with human immunodeficiency. J Pediatrics 1991; 118: 359-363.

  27. Chlebowski RT, Grosvenor MB, Bernhard NH, et al. Nutritional status, gastrointestinal dysfunction, and survival in patients with AIDS. Am J Gastroenterol 1989; 84(10): 1288-1293.

  28. Anastasi JK, Sun V. Controlling diarrhea in the HIV patient. Am J Nurs 1996; 96(8): 35-41.

  29. Kotler DP, Fogleman L, Tierney AR. Comparison of total parenteral nutrition and an oral, semielemental diet on body composition, physical function, and nutrition-related costs in patients with malabsorption due to acquired immunodeficiency syndrome. JPEN 1998; 22: 120-126.

  30. Harriman GR, Smith PD, Horne MK, et al. Vitamin B12 malabsorption in patients with the acquired immunodeficiency syndrome. Arch Intern Med 1989: 149(9): 2039-2041.

  31. Chlebowski RT, Grosvenor MB, Bernhard NH, et al. Nutritional status, gastrointestinal dysfunction, and survival in patients with AIDS. Am J Gastroenterol 1989; 84(10): 1288-1293.

  32. Miller TL, Evans ST, Onav EJ, et al. Growth and body composition in children infected with the human immunodeficiency virus. Am J Clin Nutr 1993; 57: 588-592.

  33. Kotler DP. Management of nutritional alterations and issues concerning quality of life. J Acquir Immune Defic Syndr 1997; 16(Suppl. 1): S30-S35.




2020     |     www.medigraphic.com