OBJECTIVE: The objective of this study was to establish the contribution that severe malnutrition makes to CD4 lymphopenia in HIV-infected and uninfected children and to determine the changes in CD4 count during nutritional rehabilitation. METHODS: Fifty-six children with severe malnutrition and with and without HIV infection were recruited from a pediatric ward in Lusaka for measurement of CD4 counts on admission, on discharge, and at final nutritional recovery. RESULTS: HIV-uninfected children with severe malnutrition had normal CD4 counts. In contrast, CD4 counts in HIV-infected children with severe malnutrition were reduced, more so in those without edema compared with those with edema. Mean CD4 count of HIV-infected SM children fell despite nutritional recovery so that at the time of full nutritional recovery, >85% of HIV-infected children required antiretroviral therapy. CONCLUSIONS: Severe malnutrition did not reduce the CD4 counts of children without HIV. HIV-infected children with severe malnutrition may respond well to nutritional rehabilitation, despite low CD4 counts, but nearly all require early antiretroviral therapy to prevent disease progression.
OBJECTIVE: The objective of this study was to establish the contribution that severe malnutrition makes to CD4lymphopenia in HIV-infected and uninfected children and to determine the changes in CD4 count during nutritional rehabilitation. METHODS: Fifty-six children with severe malnutrition and with and without HIV infection were recruited from a pediatric ward in Lusaka for measurement of CD4 counts on admission, on discharge, and at final nutritional recovery. RESULTS:HIV-uninfectedchildren with severe malnutrition had normal CD4 counts. In contrast, CD4 counts in HIV-infectedchildren with severe malnutrition were reduced, more so in those without edema compared with those with edema. Mean CD4 count of HIV-infected SM children fell despite nutritional recovery so that at the time of full nutritional recovery, >85% of HIV-infectedchildren required antiretroviral therapy. CONCLUSIONS: Severe malnutrition did not reduce the CD4 counts of children without HIV. HIV-infectedchildren with severe malnutrition may respond well to nutritional rehabilitation, despite low CD4 counts, but nearly all require early antiretroviral therapy to prevent disease progression.
Authors: Shirin Heidari; Lynne M Mofenson; Charlotte V Hobbs; Mark F Cotton; Richard Marlink; Elly Katabira Journal: J Acquir Immune Defic Syndr Date: 2012-02-01 Impact factor: 3.731
Authors: Geoffrey A Preidis; Eric D McCollum; Charles Mwansambo; Peter N Kazembe; Gordon E Schutze; Mark W Kline Journal: J Pediatr Date: 2011-04-13 Impact factor: 4.406