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Journal of Parenteral and Enteral Nutrition
http://pen.sagepub.com/ A.S.P.E.N. Clinical Guidelines: Nutrition Support of Children With Human Immunodeficiency Virus Infection
Nasim Sabery, Christopher Duggan and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors JPEN J Parenter Enteral Nutr 2009 33: 588 DOI: 10.1177/0148607109346276 The online version ofthis article can be found at: http://pen.sagepub.com/content/33/6/588

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A.S.P.E.N. Clinical Guidelines: Nutrition Support of Children With Human Immunodeficiency Virus Infection
Nasim Sabery, MD, MPH1; Christopher Duggan, MD, MPH2; and the American Society for Parenteral and Enteral Nutrition(A.S.P.E.N.) Board of Directors

Journal of Parenteral and Enteral Nutrition Volume 33 Number 6 November/December 2009 588-606 © 2009 American Society for Parenteral and Enteral Nutrition 10.1177/0148607109346276 http://jpen.sagepub.com hosted at http://online.sagepub.com

T

he clinical characteristics of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) inchildren differ substantially from those in adults, and these differences are important to consider in providing both medical and nutrition care. Growth failure, wasting, and loss of active lean tissue are all associated with increased mortality and accelerated disease progression. The use of highly active antiretroviral therapy (HAART) has improved the prognosis and life span of children infectedwith HIV (HIV+) and has reduced rates of wasting. However, the emergenceof HIVassociated lipodystrophy (HIVLD) has emphasized the extensive nutrition and metabolic manifestations of HIV infection. Maintaining the nutrition status of the HIV+ child is therefore crucial for optimal health outcomes.

Methodology
The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) is an organizationcomprised of healthcare professionals representing the disciplines of medicine, nursing, pharmacy, dietetics, and nutrition science. The mission of A.S.P.E.N. is to improve patient care by advancing the science and practice of nutrition
From 1Pediatric Gastroenterology and Nutrition, Children’s Hospital Boston, Harvard School of Public Health, Boston, Massachusetts; and 2Division ofGastroenterology and Nutrition, Children’s Hospital, Boston, Massachusetts. Address correspondence to: Charlene W. Compher, PhD, RD, FADA, LDN, CNSC, University of Pennsylvania School of Nursing, Claire M. Fagin Hall, 418 Curie Boulevard, Philadelphia, PA 19104-4217; e-mail: compherc@nursing.upenn.edu.

support therapy. A.S.P.E.N. vigorously works to support quality patient care, education, and research inthe fields of nutrition and metabolic support in all healthcare settings. These clinical guidelines were developed under the guidance of the A.S.P.E.N. Board of Directors. Promotion of safe and effective patient care by nutrition support practitioners is a critical role of the A.S.P.E.N. organization. The A.S.P.E.N. Board of Directors has been publishing clinical guidelines since 1986.1-3 Startingin 2007, A.S.P.E.N. has revised these clinical guidelines on an ongoing basis, reviewing about 20% of the chapters each year in order to keep them as current as possible. These A.S.P.E.N. Clinical Guidelines are based upon general conclusions of health professionals who, in developing such guidelines, have balanced potential benefits to be derived from a particular mode of medical therapy...