GROWTH FAILURE AS THE FIRST EXPRESSION OF MALNUTRITION IN CHILDREN WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Background: To define the onset, pattern, and earliest manifestations of malnutrition related to HIV infection. Methods: A retrospective cro ss-sectional analysis of changes in weight and growth in a group of 54 children with perinatally acquired HIV infection was conducted. Eight children had asymptomatic HIV infection, 26 had symptomatic infection , and 20 had symptomatic infection and were referred for nutritional s upport. Results: We found an early decline in the rate of linear growt h with a relative preservation of the weight-for-age. Weight-for-heigh t measurements were preserved until there was advanced HIV-related dis ease. Conclusions: This pattern can result in a false impression of ad equate nutrition and emphasizes the importance of longitudinal growth data of the child with HIV infection. Evidence of linear growth failur e before clinical wasting is apparent is an absolute indication for ag gressive nutritional support.