Not ART alone, regaining health by proper nutrition

The girl weighed about 20 kilograms when her mother brought her to IGICH six months back. Her hair was thin and patchy, the eyes dull. She had emaciated limbs which she moved with obvious effort. That is when staff members at IGICH’s Centre of Excellence thought of helping Sandhya back to health. Their accent was on improving the nutrient content in Sandhya’s diet.

There are not too many ART centres in the State and IGICH is the only one that has a nutritionist to counsel HIV positive patients. According to Priyamvadha C, nutritionist and dietician, Sandhya was more obsessed with dressing up and looking good, but would not eat much. “It was a challenge to convince her to eat so she could improve her health. I told her that if she ate well, she would outgrow her dresses and that would mean new outfits,” said Priyamvadha of the incentives to make a paediatric AIDS patient eat nutritious food, a challenge for their mothers.

Within months Sandhya gained weight and grew two centimetres tall.  “HIV positive patients have special needs and it is a huge challenge to feed paediatric HIV cases. HIV patients need to eat well even when they fall sick and lose all appetite. It is important for them to avoid frequent illnesses due to co-infections. Children need variety in food, but to have the right calories balanced with the right food is a huge task,” said Dr Sanjeev G S, paediatric senior consultant, ART Centre, IGICH. 

He felt that there was a need for a nutritionist at every ART centre to counsel patients, especially children about good food habits.

Recalling the initial days at the ART centre, Priyamvadha said many mothers did not know the importance of healthy food.  “When I took charge here, most children were wasted, their anthropometric measured well below the normal ranges. One-year-old AIDS patients normally must have an intake of atleast 1,000 calories, but here many had just only about 500 calories,” she said.

Many nutritionist are working in private establishments and do not wish to work in ART centres due to the stigma attached to the disease. Apart from the ART drugs, it is also important for an HIV-positive patient to consume nutritious food to maintain their CD4 count (cluster of differentiation 4), said Priyamvadha.

However RR Jannu, Project Director, Karnataka State AIDS Prevention Society (KSAPS) said that according to National AIDS Control Organisation (NACO) guidelines, nutritionists will be appointed only at the centre of excellence and not at all ART centres.  “There is no requirement for a nutritionist in all ART centres. Standard guidelines followed at the centres of excellence can be implemented,” he said.