Nutritional, clinical and immunological status of children at HIV diagnosis in the continental region of Equatorial Guinea

Abstract

objective To evaluate the nutritional, clinical and immunological status of children at HIV diagnosis in the continental region of Equatorial Guinea.methods Children <18 years diagnosed with HIV between 2009 and 2017 were included. Clinical, immunological and nutritional data were collected. Weight-for-height, weight-for-age and height-forage Z-scores were calculated using WHO Child Growth Standards. The population was assessed in two equal periods (2009-2013 and 2014-2017) from the time of diagnosis.results A total of 213 children were diagnosed with HIV (49.3% males), median age 3.8 years (IQR: 1.5-8.2). A total of 121 cases (56.8%) were at WHO clinical stage III, and 53 (24.9%) were at WHO clinical stage IV. CDC immunological stage II was diagnosed in 51/130 (39.2%) and CDC stage III in 44/130 (33.8%). About 56.2% of children were underweight (weight-for-age <À2 SD); 20.1% moderately and 36.1% severely so. About 27.6% of children were wasted (weight-for-height <À2 SD); 11.9% moderately and 15.7% severely so. About 56.3% of children were stunted (heightfor-age <À2 SD); 20.7% moderately and 35.6% severely so. The prevalence of wasting was higher in children ≤5 years than in children >5 years (36.4% vs. 19.1%, P = 0.026). In the second period, the prevalence of moderate-severe immunodeficiency decreased (87.2% to 67.0%, P = 0.018), without significant differences in the other nutritional or clinical data. Severe underweight was a risk factor for moderate-severe immunodeficiency (aOR: 4 [95% CI: 1.4-11.4], P = 0.010).conclusions We highlight a high proportion of malnutrition at the time of HIV diagnosis in Guinea´s paediatric population. Early diagnosis of HIV infection is a priority, achievable by training Guinea´s physicians to suspect HIV early, introducing HIV molecular diagnostic techniques and ensuring intensive nutritional treatment.Sustainable Development Goals (SDGs): SDG 2 (zero hunger), SDG 3 (good health and well-being), SDG 10 (reduced inequalities), SDG 17 (partnerships for the goals)

Follow-up of New Diagnoses of Mother-to-child Transmission of HIV in 2018 in 8 Latin American Countries in the Plantaids Cohort: 3 Years Later

“…In children, HIV infection leads to malnutrition, which in turn can lead to growth retardation, although ndings differ widely depending on the geographical area and are more accentuated in middle-and low-income countries [31][32][33][34][35][36] . In our work, 28.3% and 51.1% of children under 5 years of age had, respectively, a weight and height percentile of less than 3 at the rst check-up after diagnosis, with a slight improvement in subsequent check-ups, after several months or years in treatment.…”

Effects of undernutrition on mortality of HIV-infected children after initiation of antiretroviral therapy in Ethiopia: A systematic review and meta-analysis

“…HIV- infection and undernutrion coexists in a viscous cycle and deadly duo with each one fuelling the other [ 11 , 20 ]. Children living with HIV are more vulnerable to undernutrition [ 21 ] due to several mechanisms: HIV- infection exposed children for decreased appetite [ 22 ], increase energy needs as a result of infection, exacerbating of gastrointestinal infections, enteropathy and food insecurity [ 20 ].…”

“…HIV- infection and undernutrion coexists in a viscous cycle and deadly duo with each one fuelling the other [ 11 , 20 ]. Children living with HIV are more vulnerable to undernutrition [ 21 ] due to several mechanisms: HIV- infection exposed children for decreased appetite [ 22 ], increase energy needs as a result of infection, exacerbating of gastrointestinal infections, enteropathy and food insecurity [ 20 ]. Moreover, children with HIV are prone to undernutrion due to reduced food intake resulting from decreased appetite [ 23 ], poor absorption of nutrients that result of recurrent or chronic diarrhea [ 24 ], increased energy needs as a result of virus replication and opportunistic infections [ 25 ].…”