Padmapriyadarsini C, Pooranagangadevi N, Chandrasekaran K, Subramanyan Sudha, Thiruvalluvan C, Bhavani P K, Swaminathan Soumya
Department of Clinical Research, Tuberculosis Research Centre (ICMR), Chennai 600031, India.
Int J Pediatr. 2009;2009:837627. doi: 10.1155/2009/837627. Epub 2009 Jul 2.
Background. Growth failure is a common feature of children with human immunodeficiency virus (HIV) infection. Malnutrition increases mortality and may impair the response to antiretroviral treatment. Objective. Our objective was to describe the prevalence of stunting, underweight, and wasting in HIV-infected children in south India and to assess the utility of these parameters in predicting immune status. Methodology. In this cross-sectional study, anthropometric measurements and CD4 counts were performed on 231 HIV-infected children. Z scores for height for age, weight for age, and weight for height were correlated with CD4 cell counts and receiver operating characteristic curves plotted. Results. Prevalence of underweight was 63%, stunting 58%, and wasting 16%, respectively. 33-45% of children were moderately or severely malnourished even at CD4 >25%; sensitivity and specificity of stunting or underweight to predict HIV disease severity was low. Conclusions. Undernutrition and stunting are common among HIV-infected children at all stages of the disease in India. Early and aggressive nutritional intervention is required, if long-term outcomes are to be improved.
背景。生长发育迟缓是感染人类免疫缺陷病毒（HIV）儿童的常见特征。营养不良会增加死亡率，并可能损害对抗逆转录病毒治疗的反应。目的。我们的目的是描述印度南部感染HIV儿童的发育迟缓、体重不足和消瘦的患病率，并评估这些参数在预测免疫状态方面的效用。方法。在这项横断面研究中，对231名感染HIV的儿童进行了人体测量和CD4细胞计数。计算年龄别身高、年龄别体重和身高别体重的Z评分，并将其与CD4细胞计数相关联，绘制受试者工作特征曲线。结果。体重不足、发育迟缓和消瘦的患病率分别为63%、58%和16%。即使CD4>25%，仍有33 - 45%的儿童存在中度或重度营养不良；发育迟缓或体重不足预测HIV疾病严重程度的敏感性和特异性较低。结论。在印度，营养不良和发育迟缓在HIV感染儿童疾病的各个阶段都很常见。如果要改善长期预后，需要进行早期积极的营养干预。
