26 Questions
What is the primary reason for performing serial nutrition assessments in HIV+ children?
To identify growth failure and malnutrition
What is a common factor contributing to malnutrition in HIV+ children?
History of pneumonia
Why are weight measurements alone insufficient in evaluating HIV+ children?
Because they are affected by fluid shifts
What is the significance of growth failure in HIV+ children?
It is a prognostic indicator of mortality
What is the purpose of body composition studies in HIV+ children?
To evaluate loss of lean body mass
What is the benefit of HAART in HIV+ children?
It improves prognosis and life span
What is the significance of maintaining nutrition status in HIV+ children?
It is crucial for optimal health outcomes
What is a characteristic of HIV-associated lipodystrophy in children?
It emphasizes the extensive nutrition and metabolic manifestations of HIV infection
What is the primary challenge in differentiating between nutrient deficiencies secondary to HIV/AIDS and background rates of micronutrient malnutrition in developing countries?
High prevalence of micronutrient deficiencies
What is the recommended feeding practice for HIV+ mothers in resource-rich settings?
Exclusive formula feeding
What is the estimated percentage of postnatal transmission of HIV through breastfeeding?
12%-16%
What is a maternal characteristic that increases the risk of HIV transmission through breastfeeding?
Higher plasma and milk HIV viral load
What is the recommended duration of exclusive breastfeeding to reduce the risk of HIV transmission?
6 months
What is the benefit of exclusive breastfeeding in reducing diarrheal illness and mortality?
Reduces diarrheal illness and mortality
What is the recommended approach to breastfeeding in resource-poor settings, according to the World Health Organization?
Exclusive breastfeeding when replacement feeding is not feasible
What is the additional measure that can be taken to decrease the risk of HIV transmission to the infant postnatally?
Peripartum maternal and infant antiretroviral therapy
What is the primary benefit of using anthropometric measures such as mid-arm muscle area, subscapular skinfold, and triceps skinfold in HIV+ children?
To quantify fat and lean body mass
What is the primary goal of oral nutritional supplements or enteral tube feedings in HIV+ children with growth failure?
To improve weight and growth
What is the effect of antiretroviral therapy on growth in HIV+ children?
It improves weight and height while maintaining body mass index
What is the primary complication of HIV lipodystrophy in children?
Hypertriglyceridemia and hypercholesterolemia
What is the recommended supplementation for pregnant and lactating women who are HIV+?
Standard pregnancy multivitamins
What is the potential benefit of micronutrient supplementation in HIV+ children?
Better bone mineral density and reduced mortality risk
What is the primary challenge in managing HIV lipodystrophy in children?
Lack of consensus on the definition of HIV lipodystrophy
What is the effect of HAART therapy on weight and height in HIV+ children?
It increases weight and height while maintaining body mass index
What is the potential risk of high-dose vitamin A supplementation in HIV+ mothers?
Increased risk of mother-to-child HIV transmission
What is the prevalence of HIV lipodystrophy in children and adolescents?
Between 13% and 67%
Study Notes
Clinical Characteristics of HIV/AIDS in Children
- Growth failure, wasting, and loss of lean tissue increase mortality and disease progression in HIV+ children.
- HAART has improved prognosis and life span in HIV+ children, but HIV-associated lipodystrophy emphasizes the need for optimal nutrition and metabolic care.
Nutrition Assessment and Support
- Nutrition assessment should be performed at baseline and serially for HIV+ children to identify growth failure and malnutrition.
- Factors contributing to malnutrition in HIV+ children include a history of pneumonia, maternal illicit drug use, lower infant CD4 count, and increased HIV-1 viral load.
- Anthropometry and body composition studies should be performed to assess lean body mass and fat loss.
Oral Nutritional Supplements and Enteral Tube Feedings
- Oral nutritional supplements or enteral tube feedings may improve weight and growth in HIV+ children with growth failure.
- Nutritional supplements can restore weight and growth in children with growth failure, and enteral tube feeding can improve weight gain if oral interventions fail.
Antiretroviral Therapy and Growth
- Antiretroviral therapy improves growth in HIV+ children by reducing viral load and increasing weight and height.
- Children with a virologic response or significant reduction in viral load to therapy tend to have greater weight and height increases.
HIV Lipodystrophy and Metabolic Complications
- HIV-associated lipodystrophy includes abnormal blood lipid profiles, insulin resistance, and body fat redistribution.
- Children and adolescents with HIV may exhibit lipohypertrophy, lipoatrophy, or a combination of both.
- Management of lipodystrophy complications in HIV+ children is not well studied.
Supplementation for Pregnant and Lactating Women
- Supplementation with multivitamins should be provided to pregnant and lactating women who are HIV+ to improve fetal and childhood outcomes.
- Multivitamin supplementation has been linked to decreased prematurity, increased birth weight, and reduced incidence of small gestational age infants.
Micronutrient Supplementation in HIV+ Children
- Micronutrient supplementation should be considered in HIV+ children to improve their micronutrient status.
- Vitamin A supplementation has been shown to decrease diarrhea, upper respiratory tract infections, and mortality in HIV+ children.
Breastfeeding and Formula Feeding
- Women who are HIV+ in resource-rich settings are advised to formula feed exclusively to avoid HIV transmission.
- In resource-poor settings, exclusive breastfeeding is recommended due to decreased vertical transmission and infant mortality compared to mixed feeding regimens.
- Peripartum maternal and infant antiretroviral prophylaxis during breastfeeding may also decrease the risk of HIV transmission to the infant postnatally.
This quiz covers the clinical characteristics of HIV/AIDS in children, including growth failure, wasting, and nutrition care. It also discusses the importance of HAART in improving prognosis and life span.
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