HISTORICAL PERSPECTIVES ON THE EVOLUTION IN UNDERSTANDING THE IMPORTANCE OF NUTRITIONAL CARE IN PEDIATRIC HIV-INFECTION

Women, perinatally-infected infants, and sexually exposed and exploite d youths and adolescents have become a major focus of the worldwide HI V/AIDS pandemic. Increased perinatal screening, improvement in early i nfant diagnosis, and the benefits of primary HIV therapies have increa sed the numbers identified and longevity of infants and children livin g with HIV. This increase in survival is associated with HIV/AIDS beco ming a chronic multiorgan system disease that requires a multidiscipli ne comprehensive care approach. The combination of poor oral intake, i ncreased loss, and increased metabolic needs of longterm surviving HIV -infected children are obstacles to both survival and quality of life. HIV-infected children and their families need supportive care service s including nutritional as well as primary therapy. Clinical guideline s for effective nutrition interventions must be developed to prevent a nd treat failure to thrive and wasting syndrome. Gains in survival dur ation must be linked to enhanced quality of life through supportive ca re, including comprehensive nutritional services that have their effic acy documented by appropriate clinical trials.