Evaluating the Effect of Nutritional Supplementation Combined with Counseling on Nutritional Recovery in Immune-Compromised Indian Children

Abstract

Background: Malnutrition in an HIV-infected child leads to muscle wasting, micronutrient deficiency, impaired immune system and reduced ability to fight infections. It also increases the susceptibility to infections due to an increased oxidative stress. Chronic oxidative state can weaken immune systems fight against HIV. Aim: The present study was undertaken to assess the impact of nutritional supplementation on the HIV progression. Methods: This open, prospective, interventional, case control pilot study was conducted in 100 HIV infected children, age between 6 months to 15 years, fulfilling criteria of Moderate Acute Malnutrition (MAM) and criteria of thinness based on Body Mass Index as per WHO definition, either not on ART and/or on ART but failing to gain weight as observed in 2 consecutive visits. Study and control group had 50 subjects each. Intervention comprised of multigrain-micronutrient-rich laddus along with counseling for a period of 6 months for cases. Controls received nutritional counseling along with standard care. Results: The male to female ratio was 2:1, median age being 132 months in cases and 120 months in controls. The mean weight was 24.53 kg in cases and 21.46 kg in controls after 6 months (p=0.03). The mean gain in height after 6 months of intervention was 2.96 cm in cases and 2.19 cm in controls (p=0.007). The CD4 counts and antioxidant levels were statistically non-significant but showed improving trends. Conclusions: Energy dense micronutrient rich supplementation will prevent the HIV progression.