Child Nutrition Disorders Clinical Trial
Official title:
The Role of Nutrition as a Determinant of Immune Function and Pharmacological Outcome Amongst HIV Infected Malnourished Children in Uganda
This will be cohort study design with both qualitative and quantitative methods of data collection. The investigators are aiming to study 64 HIV positive children as healthy controls either initiating ART or already on ART and 86 malnourished HIV infected children on ART or naïve initiating ART and RUTF aged between 6 months to 12 years. Primary carers will be asked to provide informed consent whereby the children and primary carers will be enrolled into the study and followed up for 12 weeks.
BACKGROUND: Malnutrition and Human Immunodeficiency Virus (HIV) infection are intimately
linked and present a serious health challenge in Africa. Approximately 30-50% of children in
Uganda with severe acute malnutrition (SAM) are HIV infected. Studies on nutrition as a
determinant of immune response and drug metabolism in malnourished children are unknown.
GAP: Clinicians have noted that certain patients deteriorate after starting ART and
nutritional supplementation despite viralogical suppression and immunological improvement
with a paradoxical emergence of certain opportunistic infections, electrolyte derangement
and malnutrition hence IRIS or re-feeding syndrome (RF). There is paucity of data on
nutrition as a determinant of immune and pharmacological response amongst HIV infected
malnourished children despite malnutrition being common.
HYPOTHESIS: Well-nourished HIV infected children ART naïve or experienced will have a better
nutritional, clinical, immunological and pharmacological outcome than malnourished children
ART naïve or experienced.
METHODS: A cohort design studying 75 malnourished HIV infected children on ART and RUTF
comparing them to 75 well-nourished children ART naive or experienced aged between 6 months
to 12 years after primary carers have provided informed consent will be enrolled into the
study and followed up for 12 weeks.
IMPACT: This study will endeavor to provide appropriate information that will enhance the
management of malnourished HIV infected children in the context of both ART and RUTF and
their impact on immune response and drug metabolism. The study will also generate other
research questions that need to be addressed in order to optimize HIV services amongst
malnourished children.
;
Allocation: Non-Randomized, Endpoint Classification: Pharmacokinetics/Dynamics Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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