A colonização nasal por Staphylococcus aureus e a infecção pelo HIV representam problemas de saúde pública de preocupação mundial. O objetivo geral foi identificar os fatores de risco para a colonização nasal por Staphylococcus aureus em pessoas vivendo com HIV/aids. Para tanto, foi realizado um estudo tipo caso-controle, com pessoas vivendo com HIV/aids internadas nas unidades especializadas na assistência às doenças infecciosas de um hospital de ensino no interior paulista. A coleta de dados ocorreu de janeiro/2013 a fevereiro/2015, por meio de entrevista individual contemplando dados sociodemográficos e clínicos, além da coleta da secreção nasal com auxílio do swab em meio Stuart, ambos nas primeiras 24 horas de internação. As amostras foram encaminhadas e processadas pelo Laboratório de Microbiologia da própria instituição. Os critérios de inclusão foram: ter idade acima de 18 anos, ser soropositivo ao HIV, estar internado. Nas análises estatísticas foram realizados os testes qui-quadrado de Pearson, Exato de Fisher, t-Student, Wilcoxon e Regressão Logística Univariada e Multivariada, por meio do software SAS®. Os dados estão apresentados em tabelas e figuras. O presente estudo foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem de Ribeirão Preto (No CAAE 38990114.5.0000.5393) e pela instituição co-participante (No CAAE 38990114.5.3001.5440). Participaram do estudo 240 pessoas vivendo com HIV/aids, sendo 120 Casos e 120 Controles, houve predominância do sexo masculino em 65,0% dos Casos e 55,0% dos Controles, 35,8% dos Casos estavam na faixa etária de 30 a 39 anos e 45,8% dos Controles tinham idade de 40 a 49 anos, a etnia predominante foi a branca para Casos e Controles, 74,2% e 64,2%, respectivamente. Os grupos foram homogêneos entre si em relação ao sexo, etnia e escolaridade. A média do tempo de diagnóstico foi de 9 anos para Casos e 8,8 anos para Controles. O modelo final de regressão logística evidenciou como fatores de risco associados à colonização nasal por Staphylococcus aureus em pessoas vivendo com HIV/aids, ser da etnia branca, p=0,05 (OR:1,85; IC95% 1,00 - 3,57); ter carga viral >40 cópias/mL, p= 0,03 (OR: 2,90; IC95% 1,15 - 7,30); estar com contagem de LT-CD4+ <200 células/mm3 p=0,001 (OR: 2,71; IC95% 1,53 - 4,81); e apresentar doença oportunista p=0,014 (OR: 2,09; IC95% 1,20 - 3,67). Além disso, foi evidenciado como fator de proteção para a colonização nasal pelo Staphylococcus aureus em pessoas vivendo com HIV/aids o uso de antirretroviral p=0,008 (OR: 0,45; IC95% 0,25 - 0,81). Concluímos que a colonização nasal por Staphylococcus aureus nas pessoas vivendo com HIV/aids foi associada aos fatores: etnia, carga viral, contagem de LT-CD4+ , infecção oportunista e uso de antirretroviral / Staphylococcus aureus nasal colonization and HIV infection represent public health problems of global concern. The overall objective was to identify the risk factors for nasal colonization by Staphylococcus aureus in people living with HIV / AIDS. Therefore, a case-control study was conducted, with people living with HIV / AIDS hospitalized at the units specialized in infectious disease care at a teaching hospital in the interior of São Paulo. Data were collected from January / 2013 to February / 2015 by means of an individual interview, including sociodemographic and clinical data, as well as the collection of nasal secretions with the aid of swab in Stuart\'s medium, both during the first 24 hours of hospitalization. The samples were sent and processed by the Laboratory of Microbiology of the institution itself. The inclusion criteria were: to be over 18 years of age, to be known as infected HIV, to be hospitalized. Statistical analyzes were performed using the Pearson chi-square test, Fisher\'s exact test, Student t-test, Wilcoxon test, and Univariate and Multivariate logistic regression using the SAS® software. The data are presented in tables and figures. The present study was approved by the Research Ethics Committee of the Ribeirão Preto College of Nursing (CAAE 38990114.5.0000.5393) and by the co- participating institution (CAAE 38990114.5.3001.5440). A total of 240 people living with HIV / AIDS participated in the study, of which 120 were Cases and 120 Controls; 65.0% of Cases and 55.0% of Controls were male: 35.8% of Cases were in the age group of 30 at 39 years and 45.8% of the Controls were aged from 40 to 49 years, the predominant ethnicity was white for Cases and Controls, 74.2% and 64.2%, respectively. The groups were homogeneous among themselves in relation to gender, ethnicity and schooling. The mean time of diagnosis was 9 years for Cases and 8.8 years for Controls. The final logistic regression model showed that the risk factors associated with Staphylococcus aureus nasal colonization in people living with HIV / AIDS were white, p = 0.05 (OR: 1.85, 95% CI: 1.00 - 3.57); having viral load> 40 copies / mL, p = 0.03 (OR: 2.90; IC95% 1.15 - 7.30); being with LT-CD4+ <200 cells / mm3 p = 0.001 (OR: 2.71; IC95% 1.53 - 4.81); and present opportunistic disease p = 0.014 (OR: 2,09; IC95% 1,20 - 3,67). In addition, it was also obtained by the final regression final model that the use of antiretroviral therapy is a protection factor of p = 0.008 (OR: 0.45; 95% CI 0.25 - 0.81) for nasal colonization by Staphylococcus aureus. We conclude that nasal colonization by Staphylococcus aureus in people living with HIV/AIDS was associated with factors: ethnicity, viral load, LT-CD4+ count, opportunistic infection, and antiretroviral use

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2016-07-06T14:36:10Z No. of bitstreams: 1 arlindosjunior_dissert.pdf: 1444679 bytes, checksum: 3c39df3ac849b54a266ccc0a6c1cc238 (MD5) / Made available in DSpace on 2016-07-06T14:36:10Z (GMT). No. of bitstreams: 1 arlindosjunior_dissert.pdf: 1444679 bytes, checksum: 3c39df3ac849b54a266ccc0a6c1cc238 (MD5) Previous issue date: 2010-11-25 / Hereby we present the epidemiological and clinical profile of the HIV-infected group before and during the HAART era from a tertiary care hospital catering to a large population from the Southeastern Brazilian region. A retrospective, cross-sectional and descriptive study was carried out, which involved the analysis of the medical records of patients diagnosed with HIV-1/AIDS admitted to Hospital Escola Emílio Carlos, located in the municipality of Catanduva, State of São Paulo, Brazil. In both pre-HAART and HAART periods, HIV-1 infection was more prevalent in men. Heterosexuality and secondary education were the risk facts for acquisition of the disease in the HAART period. Statistically significant association was only observed for co-infection with HIV-1/Hepatitis C in the pre-HAART era and the number of patients with opportunistic illness (OI) was lower in the HAART period. Among all these OI it is worth mentioning pulmonary pneumocystosis, since despite being frequent in the two periods, its occurrence was considerably greater in the pre-HAART era. Concerning the distribution of OI according to the HIV-1 viral load and serial count of T CD4+ lymphocytes, a significant association was observed. The association between the number of deaths by OI and the survival rate of less than 1 year in the HAART period was significant. The clinical and epidemiological picture of a specialized HIV-1/AIDS Center in a municipality in the southeastern region of Brazil is consistent with the current epidemiology of AIDS in the country. In conclusion, our results indicate that the OI are still important causes of morbi-mortality among HIV-1/AIDS infected patients in the municipality of Catanduva, particularly pulmonary pneumocystosis, tuberculosis and cryptococcal meningoencephalitis. We are aware that retrospective studies such as ours, which involve the review of patients’ medical records, may present some limitations arising from the scarcity or even absence of information. / Nós apresentamos o perfil clínico e epidemiológico de indivíduos portadores do HIV-1 antes e durante a era da terapia antirretroviral altamente ativa (HAART) de um hospital terciário que atende uma grande população da região Sudeste do Brasil. Estudo retrospectivo, transversal e descritivo que envolveu a análise de prontuários dos pacientes diagnosticados com HIV-1/AIDS atendidos no Hospital Escola Emílio Carlos, localizado no município de Catanduva, Estado de São Paulo, Brasil. Em ambos os períodos pré-HAART e HAART, a infecção por HIV-1 foi mais prevalente em homens. Heterossexualidade e nível de escolaridade do ensino médio foram os fatores de risco para aquisição da doença no período HAART. Associação estatisticamente significante foi observada somente para a coinfecção HIV-1/Hepatite C na era pré-HAART e o número de pacientes com infecções oportunistas (IO) foi menor no período HAART. Entre todas estas IO vale à pena mencionar a pneumocistose pulmonar, pois apesar de ser freqüente nos dois períodos, sua ocorrência foi significativamente maior na era pré-HAART. Quanto à distribuição de IO de acordo com a carga viral do HIV-1 e contagem de linfócitos T CD4 +, uma associação significativa foi observada. A associação entre o número de mortes por IO e a taxa de sobrevivência de menos de um ano na era HAART foi significativa. O quadro clínico e epidemiológico de um centro de atendimento especializado em HIV-1/AIDS em um município na região sudeste do Brasil é compatível com a epidemiologia atual da AIDS no país. Em conclusão, nossos resultados indicam que as IO ainda são importantes causas de morbi-mortalidade entre os pacientes infectados por HIV-1/AIDS no município de Catanduva, particularmente a pneumocistose pulmonar, a tuberculose e a meningoencefalite criptococócica. Estamos cientes de que estudos retrospectivos como o nosso, que envolvem a revisão de prontuários médicos, podem apresentar algumas limitações decorrentes da escassez, ou mesmo da ausência de informações.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / ApÃs duas dÃcadas dos primeiros registros da SÃndrome da ImunodeficiÃncia Adquirida (Aids) no Brasil, a assistÃncia à saÃde de pessoas com HIV/Aids ainda à um desafio. Nesse contexto, discute-se a necessidade de efetivar uma polÃtica de atenÃÃo integral a essa populaÃÃo, em especial à saÃde bucal, sendo que o Programa de SaÃde da FamÃlia (PSF) representa uma possibilidade potencial de enfrentamento desse problema. Este estudo tem como objetivo caracterizar as estratÃgias polÃticas e organizacionais da atenÃÃo odontolÃgica a pessoas vivendo com HIV/Aids no MunicÃpio de Fortaleza, CearÃ, e verificar a existÃncia de assistÃncia odontolÃgica na rede bÃsica do MunicÃpio de Fortaleza a pessoas portadoras da doenÃa. A metodologia consistiu, primeiramente, em pesquisa qualitativa documental baseada em revisÃo sistemÃtica da literatura e documentos tÃcnicos do MinistÃrio da SaÃde, do Estado do Cearà e do MunicÃpio de Fortaleza. No segundo momento, optou-se pelo estudo quantitativo, usando como fonte de dados secundÃrios o Sistema de InformaÃÃo de Agravos de NotificaÃÃo - SINAN e, por fim, uma descriÃÃo da realidade por meio da aplicaÃÃo de um questionÃrio a 186 cirurgiÃes-dentistas (CDs) inseridos no PSF de Fortaleza. A anÃlise baseou-se em estatÃstica descritiva, utilizando tabelas e mapas temÃticos para possibilitar uma distribuiÃÃo espacial da doenÃa em Fortaleza, alÃm da anÃlise documental. Encontrou-se pouca documentaÃÃo oficial (polÃticas e diretrizes) relacionada à atenÃÃo a saÃde bucal de pessoas com HIV/Aids, em especial, na esfera federal, que tem como principal material disponÃvel artigos e manuais, em sua maioria, relacionados à biosseguranÃa e a lesÃes bucais oportunistas. No nÃvel municipal, encontrou-se a maior parte da documentaÃÃo oficial. Observou-se que, atà 2007, o nÃmero de pessoas com HIV/Aids vivas residentes em Fortaleza foi de 3.311 e que essas pessoas residem distribuÃdas por todo o MunicÃpio. Constatou-se que mais da metade (58,06%) dos CDs que trabalham no PSF tÃm conhecimento sobre a presenÃa de pessoas portadoras de HIV/Aids, entretanto, apenas 29,57% confirmaram ter atendido essa demanda na unidade onde trabalham. O atendimento odontolÃgico destinado a esse mesmo pÃblico nÃo ocorreu igualmente em todo o municÃpio de Fortaleza, sendo concentrado mais em alguns locais, destacando-se a Secretaria Executiva Regional II. Conclui-se que, apesar do Programa Nacional de DST/Aids ser reconhecido internacionalmente, hà a necessidade de avanÃar na discussÃo sobre a saÃde bucal dessa populaÃÃo e que a assistÃncia odontolÃgica a pessoas com HIV/Aids nÃo està consolidada como aÃÃo de saÃde bucal do PSF, embora jà exista uma polÃtica municipal direcionada para esse fim, indicando a necessidade de reorganizaÃÃo e reorientaÃÃo da assistÃncia odontolÃgica a pessoas com HIV/Aids. / Two decades following the first cases of the Acquired Immunodeficiency Syndrome (Aids) registered in Brazil, health care for individuals living with HIV/Aids is still a significant challenge. Within this context, the need to implement an integrated health policy for this group has been frequently discussed. This is particularly relevant for oral health services, where the Family Health Program (PSF-Programa SaÃde da FamÃlia) offers a potential tool to address this issue. This study has the objective of examining the political and organizational oral health strategies for people with HIV/Aids in the municipality of Fortaleza, Cearà state, and verifying the extent of oral care services in the municipal basic health structure. The methodology consisted of a qualitative and documentary study based on a systematic review of the literature and technical guidelines issued by the Ministry of Health and the secretariats of the State of Cearà and Municipality of Fortaleza. Additionally, the researchers used a quantitative approach using secondary data from the National Notifiable Diseases Health Information System (SINAN - Sistema de InformaÃÃo de Agravos de NotificaÃÃo). Finally, a snapshot of current conditions was taken by means of a questionnaire applied to 186 dental surgeons (DS) working in the PSF in Fortaleza. Analysis was undertaken using descriptive statistics, in particular tables and thematic maps to display the spatial distribution of the disease in Fortaleza, in addition to the literature review. Relatively little official documentation was found (policies and technical guidelines) relative to the oral health services for people living with HIV/Aids, especially at the federal level which only has articles and manuals available, mostly dealing with biosecurity and opportunistic oral lesions. The majority of official documentation was found at the municipal level. The study showed that until 2007, there were 3,311 people living with HIV/Aids in Fortaleza and that these individuals reside throughout the municipality. It was also determined that over half (58.06%) of the DS working in the PSF are aware of the presence of people with HIV/Aids in their working area, yet only 29.57% affirmed that they had treated members of this group in their health unit. The oral health care offered to this group was not equally distributed in the municipality; rather it was concentrated in a few locations, particularly the Executive Secretariat of Region II. It has been concluded that, despite international recognition given to the Brazilian National STD/Aids Program, it is necessary to move forward the debate on oral health services offered to this population group and that the treatment given to people with HIV/Aids has not been consolidated as a key component of oral health services offered by the PSF. This goes against a municipal policy already in existence directed towards this goal, thereby indicating the need for the reorganization and reorientation of the oral health care available to people with HIV/Aids.

A colonização nasal por Staphylococcus aureus e a infecção pelo HIV representam problemas de saúde pública de preocupação mundial. O objetivo geral foi identificar os fatores de risco para a colonização nasal por Staphylococcus aureus em pessoas vivendo com HIV/aids. Para tanto, foi realizado um estudo tipo caso-controle, com pessoas vivendo com HIV/aids internadas nas unidades especializadas na assistência às doenças infecciosas de um hospital de ensino no interior paulista. A coleta de dados ocorreu de janeiro/2013 a fevereiro/2015, por meio de entrevista individual contemplando dados sociodemográficos e clínicos, além da coleta da secreção nasal com auxílio do swab em meio Stuart, ambos nas primeiras 24 horas de internação. As amostras foram encaminhadas e processadas pelo Laboratório de Microbiologia da própria instituição. Os critérios de inclusão foram: ter idade acima de 18 anos, ser soropositivo ao HIV, estar internado. Nas análises estatísticas foram realizados os testes qui-quadrado de Pearson, Exato de Fisher, t-Student, Wilcoxon e Regressão Logística Univariada e Multivariada, por meio do software SAS®. Os dados estão apresentados em tabelas e figuras. O presente estudo foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem de Ribeirão Preto (No CAAE 38990114.5.0000.5393) e pela instituição co-participante (No CAAE 38990114.5.3001.5440). Participaram do estudo 240 pessoas vivendo com HIV/aids, sendo 120 Casos e 120 Controles, houve predominância do sexo masculino em 65,0% dos Casos e 55,0% dos Controles, 35,8% dos Casos estavam na faixa etária de 30 a 39 anos e 45,8% dos Controles tinham idade de 40 a 49 anos, a etnia predominante foi a branca para Casos e Controles, 74,2% e 64,2%, respectivamente. Os grupos foram homogêneos entre si em relação ao sexo, etnia e escolaridade. A média do tempo de diagnóstico foi de 9 anos para Casos e 8,8 anos para Controles. O modelo final de regressão logística evidenciou como fatores de risco associados à colonização nasal por Staphylococcus aureus em pessoas vivendo com HIV/aids, ser da etnia branca, p=0,05 (OR:1,85; IC95% 1,00 - 3,57); ter carga viral >40 cópias/mL, p= 0,03 (OR: 2,90; IC95% 1,15 - 7,30); estar com contagem de LT-CD4+ <200 células/mm3 p=0,001 (OR: 2,71; IC95% 1,53 - 4,81); e apresentar doença oportunista p=0,014 (OR: 2,09; IC95% 1,20 - 3,67). Além disso, foi evidenciado como fator de proteção para a colonização nasal pelo Staphylococcus aureus em pessoas vivendo com HIV/aids o uso de antirretroviral p=0,008 (OR: 0,45; IC95% 0,25 - 0,81). Concluímos que a colonização nasal por Staphylococcus aureus nas pessoas vivendo com HIV/aids foi associada aos fatores: etnia, carga viral, contagem de LT-CD4+ , infecção oportunista e uso de antirretroviral / Staphylococcus aureus nasal colonization and HIV infection represent public health problems of global concern. The overall objective was to identify the risk factors for nasal colonization by Staphylococcus aureus in people living with HIV / AIDS. Therefore, a case-control study was conducted, with people living with HIV / AIDS hospitalized at the units specialized in infectious disease care at a teaching hospital in the interior of São Paulo. Data were collected from January / 2013 to February / 2015 by means of an individual interview, including sociodemographic and clinical data, as well as the collection of nasal secretions with the aid of swab in Stuart\'s medium, both during the first 24 hours of hospitalization. The samples were sent and processed by the Laboratory of Microbiology of the institution itself. The inclusion criteria were: to be over 18 years of age, to be known as infected HIV, to be hospitalized. Statistical analyzes were performed using the Pearson chi-square test, Fisher\'s exact test, Student t-test, Wilcoxon test, and Univariate and Multivariate logistic regression using the SAS® software. The data are presented in tables and figures. The present study was approved by the Research Ethics Committee of the Ribeirão Preto College of Nursing (CAAE 38990114.5.0000.5393) and by the co- participating institution (CAAE 38990114.5.3001.5440). A total of 240 people living with HIV / AIDS participated in the study, of which 120 were Cases and 120 Controls; 65.0% of Cases and 55.0% of Controls were male: 35.8% of Cases were in the age group of 30 at 39 years and 45.8% of the Controls were aged from 40 to 49 years, the predominant ethnicity was white for Cases and Controls, 74.2% and 64.2%, respectively. The groups were homogeneous among themselves in relation to gender, ethnicity and schooling. The mean time of diagnosis was 9 years for Cases and 8.8 years for Controls. The final logistic regression model showed that the risk factors associated with Staphylococcus aureus nasal colonization in people living with HIV / AIDS were white, p = 0.05 (OR: 1.85, 95% CI: 1.00 - 3.57); having viral load> 40 copies / mL, p = 0.03 (OR: 2.90; IC95% 1.15 - 7.30); being with LT-CD4+ <200 cells / mm3 p = 0.001 (OR: 2.71; IC95% 1.53 - 4.81); and present opportunistic disease p = 0.014 (OR: 2,09; IC95% 1,20 - 3,67). In addition, it was also obtained by the final regression final model that the use of antiretroviral therapy is a protection factor of p = 0.008 (OR: 0.45; 95% CI 0.25 - 0.81) for nasal colonization by Staphylococcus aureus. We conclude that nasal colonization by Staphylococcus aureus in people living with HIV/AIDS was associated with factors: ethnicity, viral load, LT-CD4+ count, opportunistic infection, and antiretroviral use

Thesis (Mnutr)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: Problem Definition: In the context of HIV/AIDS malnutrition is almost universal among children, and of the adverse effects of Protein Energy Malnutrition, the most frequent seems to be the occurrence of opportunistic infections with micro-organisms such as oral Candida. Objective: The aim of this study was to determine the nutritional status of children with oral complications in relation to HIV/AIDS as well as the effects of the oral lesions on nutritional status. Subjects/setting: The subjects of study were 24 children co-infected with TB and HIV who were admitted consecutively to the paediatric ward of Brooklyn Chest Hospital in Cape Town, South Africa. The nutritional status of the children was assessed over a maximum period of six months by nutrient intake, anthropometric status, and by biochemical parameters and clinical and oral examination on admission and at discharge from hospital. Results: Children with HIVand TB infection presenting with or without oral lesions were similarly malnourished throughout the period of hospitalization. There was no improvement in the nutritional status as indicated by height and weight measurements. Throughout the time of hospitalization, 7% of the children had a combination of stunting, underweight and wasting. Average nutrient intake was not found to be higher than the Recommended Dietary Allowance (RDA) in any of the children. At the time of admission to hospital and at discharge, carbohydrate intake provided most of the daily energy (36% and 42%, the difference not being statistically significant). There was a significant increase in the intake of energy (p=O.04) and a decrease in total fat intake (p=O.03) at discharge. Although not significant, mean protein intake at admission was higher than at time of discharge. Selected sub-optimal biochemical values were prevalent among the children studied, with 45% and 41% showing low serum albumin values «2.9g/dL) at the time of admission and at discharge respectively. Both on admission and at discharge, 38% of the children had Haemoglobin levels below normal values. Serum ferritin levels below normal values were present in almost all the children and the trend was similar for the prevalence of low zinc values. Sub-normal plasma retinol was present in 79% of the children at time of admission, while only 21% had deficient values at time of discharge (p=O.03). On admission, 29% of the children had vitamin evalues below the normal range whereas at time of discharge 17% of the children had values below normal (p=O.04). A total of 29% children presented with oral complications on admission. These included oral herpes, oral thrush, reflux, bleeding gums and stomatitis/angular cheilosis. Two children were asymptomatically colonized with Candida of the oral cavity. Mean total protein intake was higher (p=O.057) among the children who were not diagnosed with oral complications. Conclusions: This study confirmed that malnutrition is not only a common and serious problem associated with HIVand AIDS, but also that nutritional problems cannot be dealt with in isolation where Opportunistic Infections are present. The severity of malnutrition depends on various factors including oral complications. Additionally, appropriate management and treatment of tuberculosis did not appear to affect the nutritional status significantly. Recommendations: On the basis of these findings, and because of the increased risk of growth failure and developmental delays, children should be referred for full nutritional evaluation as soon as possible after diagnosis of HIV -infection. In addition, there is a need for intervention programmes to identify the immediate underlying causes of malnutrition and the ways in which such causes interact, in order to ensure that such interventions increase the resistance of HIV infected infants and children to the disease. / AFRIKAANSE OPSOMMING: Probleemdefiniëring: Binne die konteks van MIVNIGS is wanvoeding bykans universeelonder kinders en van die nadelige effekte van proteïen energie wanvoeding is die voorkoms van opportunistiese infeksies (Ol) met mikro-organismes soos orale candida die algemeenste. Doelwit: Die doel van dié studie was om die voedingstatus van kinders met orale komplikasies in verhouding tot MIVNIGS en die effek van orale letsels op voedingstatus, te bepaal. Proefpersone/omgewing: 'n Groep van 24 kinders, met beide tuberkulose en MIVNIGSinfeksie, wat agtereenvolgend in die kindersaal van Brooklyn Bors-Hospitaal in Kaapstad, Suid- Afrika opgeneem is, is bestudeer. Vir 'n periode van ses maande is die kinders se voedingstatus geassesseer deur middel van voedingstofinname, antropometriese status en biochemiese parameters met opname in en ontslag uit die hospitaal. Kliniese en orale ondersoeke was op elke kind uitgevoer met opname sowel as ontslag. Resultate: Kindres met HIV en tuberkulose, met of sonder orale letsels, het soortgelyke wanvoeding tydens hospitalisering ervaar het. Volgens antropometriese metings was daar geen verbetering in die voedingstatus nie. 'n Kombinasie van belemmerde groei, ondergewig en uittering het in 7% van die kinders tydens hospitalisering voorgekom. Nie een van die gemiddeldes van die voedingstowwe was hoër as die Aanbevole daaglikse toelatings (ADT) in enige van die kinders wat bestudeer is nie. Met opname sowel as ontslag, was koolhidraatinname die grootste energieverskaffer met onderskeidelik 36% en 42% (alhoewel die verskil nie statisties beduidend was nie). Daar was 'n beduidende toename in energie-inname (p=O.04) en 'n afname in totale vetinname (p=O.03) met ontslag. Alhoewel nie beduidend nie, was die gemiddelde proteïeninname hoër met ontslag. Die voorkoms van geselekteerde sub-optimale biochemiese waardes met toelating en ontslag wys dat onderskeidelik 45% en 41% van die kinders lae serum albumienwaardes «2.9g/dL) getoon het. Subnormale plasma retinol het in 79% van die kinders met toelating voorgekom, terwyl slegs 21% gebrekkige waardes (p=O.03) met ontslag getoon het. Tydens opname, sowel as met ontslag, was 38% van die kinders se hemoglobienvlakke laer as die normale. Serum ferritienvlakke was amper by al die kinders laer as die normale vlakke te bespeur, met sinkvlakke wat op soortgelyke lae vlakke voorkom. Met toelating was 29% van die kinders se Vitamien C-waardes laer as normaal en met ontslag was sowat 17% se waardes steeds laer as die normaal (p=O.04). Met toelating het 29% van die kinders orale komplikasies getoon. Ingeslote hierby was orale herpes, orale sproei, refluks, bloeiende tandvleise en stomatis/ angulêre cheilose. Slegs twee kinders was asimptomaties met orale Candida van die mondholte gediagnoseer. Die gemiddelde proteïeninname was hoër (p=O.057) onder die kindres wat nie orale komplikasies getoon het nie. Gevolgtrekking: Hierdie studie bevestig dat wanvoeding me net 'n algemene en ernstige probleem is wat met MIV en VIGS geassosieer word nie, maar ook in die teenwoordigheid van opportunistiese infeksies, die voedingsprobleem nie in isolasie gehanteer kan word nie. Die graad van wanvoeding hang af van ander faktore, insluitende orale komplikasies. Voldoende behandeling van TB het ook nie 'n beduidende effek op voedingstatus gehad nie. Aanbevelings: Op hierdie bevindings gebaseer, en as gevolg van die verhoogde risiko VIr belemmerde groei en vertraagde ontwikkeling wat al die liggaamstelsels van MIV -positiewe kinders affekteer, moet kinders so gou as moontlik nadat die MIV-infeksie gediagnoseer is, vir volle voedingsevaluasies verwys word. Daarmee gepaardgaande is daar 'n behoefte aan programme wat die onmiddellike onderliggende oorsake van wanvoeding identifiseer, asook om interaksie van hierdie oorsake met HIV vas te stel, ten einde intervensies wat weerstand van HIVkinders en-babas verbeter, positieftoe te pas.