Treatment of severe acute malnutrition in HIV-infected children

Severe acute malnutrition is defined by a very low weight for height, by visible severe wasting, or by the presence of nutritional oedema. It affects about 20 million children under five years old, and is associated with 1–2 million preventable deaths every year.

There is considerable overlap in presentation of severe acute malnutrition and HIV infection in children, especially in poor areas.

To reduce mortality, WHO recommends that voluntary counselling and testing should be available for children with severe acute malnutrition and for their mothers. If diagnosed as HIV-positive, they should qualify for cotrimoxazole prophylaxis to prevent the risk of contracting pneumonia and other infections, and for antiretroviral therapy when indicated. At the same time, children who are known to be HIV-positive and who develop severe acute malnutrition should have access to therapeutic feeding to improve their nutritional status.