e-Library of Evidence for Nutrition Actions (eLENA)

Management of HIV-infected children under 5 years of age with severe acute malnutrition

In children who are under 5 years of age, severe acute malnutrition is defined by a very low weight-for-height/weight-for-length or clinical signs of bilateral pitting oedema. A very low mid-upper arm circumference also indicates severe acute malnutrition in children who are 6–59 months of age. Severe acute malnutrition affects an estimated 19 million children under 5 years of age worldwide and is estimated to account for approximately 400,000 child deaths each year.

HIV infection and undernutrition often affect the same populations, particularly in resource-limited settings, and moderate or severe acute malnutrition commonly affects HIV-infected children. HIV-infection increases susceptibility to persistent diarrhoea and opportunistic infections which can greatly impact the health of severely malnourished children and HIV-infected children with severe acute malnutrition are nearly three times more likely to die during treatment (for severe acute malnutrition), compared to their HIV-negative counterparts.

WHO recommendations

Children under 5 years of age with severe acute malnutrition who are HIV-infected and who qualify for lifelong antiretroviral therapy should be started on antiretroviral drug treatment as soon as possible after stabilization of metabolic complications and sepsis.

Children under 5 years of age with severe acute malnutrition who are HIV-infected should be managed with the same therapeutic feeding approaches as children with severe acute malnutrition who are not HIV-infected.


This is a summary of WHO recommendations on the management of HIV-infected children under 5 years of age with severe acute malnutrition. The full set of recommendations can be found in the guidelines and guidance documents under ‘WHO documents’ below.

WHO documents


GRC-approved guidelines
Other guidance documents

Evidence


Systematic reviews used to develop the guidelines
Clinical trials
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Last update:

28 July 2014 17:08 CEST

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Category 1 intervention

Guidelines have been recently approved by the WHO Guidelines Review Committee

Essential Nutrition Actions

This intervention is a component of managing children with SAM, which is an Essential Nutrition Action targeting the first 1000 days of life.