HIV-Associated Polyneuropathy in Resource-Limited Settings: Genetic Predisposition and Vitamin Variations

Ndakala, Frank; Oyugi, Julius; Oluka, Margaret O.

doi:10.4236/wja.2017.72010

Cited by 4 publications

(2 citation statements)

References 79 publications

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“…These include studies in Botswana, Ethiopia, Senegal and China with prevalence of undernutrition at 28.5, 25.2, 22.9 and 37.2 per cent, respectively (Benzekri et al , 2015; Gedle et al , 2015; Hu et al , 2011; Nnyepi, 2009). Previous studies have attributed the prevalence of high undernutrition among people living with HIV/AIDS to chronic diarrhoea, high nutrient requirement, co-infection, reduction in dietary intake/eating difficulties, abnormal protein metabolism, malabsorption, increased energy expenditure, abnormal utilization of substrates, food insecurity and hunger (Gedle et al , 2015; Hsu and Pencharz, 2005; Martinez et al , 2014; Ndakala et al , 2017; Rose et al , 2014; Weiser et al , 2014).…”

Section: Discussionmentioning

confidence: 99%

Nutritional and health status of people living with HIV/AIDS in the eastern region of Ghana

Apungu

Apprey

Amewu

et al. 2019

NFS

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Purpose The purpose of the study is to assess the nutritional and health status of people living with HIV/AIDS (18-60 years) in selected health facilities in the eastern region of Ghana and to determine the influence nutrition support programmes (NSP) have on the nutritional and health status of people living with HIV/AIDS. Design/methodology/approach A retrospective study design was used. Purposive and convenience sampling was used to select four hospitals and 200 beneficiaries and non-beneficiaries of the NSP. A structured questionnaire was used to collect the sociodemographic, anthropometric, biochemical and clinical history of the participants. Dietary intake was assessed with food frequency and 24-h dietary intake questionnaires. Previous data from the medical record within three to six months before the research was collected and compared with current data. Findings The prevalence of underweight (using body mass index) was 17 per cent and overweight/obesity was 37 per cent. Most respondents had adequate consumption of phosphorus (70.5 per cent); inadequate intake of calcium (95 per cent), vitamin E (77.5 per cent) and vitamin A (94 per cent); and excess intakes of sodium (93 per cent), selenium (77 per cent), copper (83.5 per cent) and manganese (76 per cent). There was no significant difference in nutrient intake of beneficiaries and non-beneficiaries of the NSP, although there were significant differences in the frequency of consumption of fruits (p < 0.001), vegetables (p < 0.001), legumes (p = 0.002), animal foods (p < 0.001) and cereals, grains and starch (p < 0.001) between beneficiaries and non-beneficiaries of NSP. About 38 and 20 per cent of respondents, respectively, had low haemoglobin (Hb < 11 g/dL) and high viral load (1,000 cp/mL). Comparing the current and previous (three to six months before the study) health and nutritional status of beneficiaries and non-beneficiaries of NSP, among the beneficiaries of NSP, monocytes increased by 40.6 per cent (p = 0.028) and mean weight decreased by 2.4 per cent (p = 0.007), Hb decreased by 7.1 per cent (p = 0.27) and viral load decreased by 4.2 per cent (p = 0.49), whereas among the non-beneficiaries, mean weight decreased by 0.05 per cent (p = 0.95) and Hb increased by 9.6 per cent (p = 0.06) and monocytes increased (p = 0.28) and viral load increased by 98.2 per cent (p = 0.34). Research limitations/implications A significant proportion of people living with HIV/AIDS had a high prevalence of underweight and overweight/obesity, inadequate nutrients intake and high viral load. The NSP for people living with HIV/AIDS in the eastern region of Ghana did not significantly influence the nutritional and health status of these people. Practical implications Knowing the nutritional status will help health institutions plan activities towards improving the health and nutritional status of people living with HIV/AIDS. This research is aimed at not only contributing to the existing body of knowledge but also making recommendations of action towards improving NSPs of people living with HIV/AIDS. Social implications Improvement in nutritional and health status of people living with HIV/AIDS will help reduce morbidity and mortality and its related cost to families, communities and the nation. Originality/value This study is first to determine the influence of NSPs on nutritional and health status of people living with HIV/AIDS in the eastern region of Ghana.

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Section: Discussionmentioning

confidence: 99%

Nutritional and health status of people living with HIV/AIDS in the eastern region of Ghana

Apungu

Apprey

Amewu

et al. 2019

NFS

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“…The extent to which nutrition played a role was not established in this population. Vitamin deficiencies have been described as a common co-existence with HIV infection in poorer communities resulting in neuropathies [30].…”

Section: Possible Mechanismsmentioning

confidence: 99%

HIV infection, seasonality and younger age predicting incident Bell’s palsy among black South Africans

et al. 2020

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Background Although South Africa (SA) is facing a high prevalence of HIV infection, there is no literature from this region on a link between Bell’s palsy and HIV. The aim of this study was to identify the occurrence of Bell’s palsy in relation to demographics, seasons and HIV status among black South Africans. Methods This retrospective cohort was conducted among adult black patients, without Bell’s palsy in 2003, presenting to the neurology outpatients department at Dr. George Mukhari Academic hospital, Pretoria, South Africa, between 2004 (study baseline) and 2012 (end test). Gender, age, HIV status, and seasons were potential predictors of Bell’s palsy using Cox regression model and Kaplan Meier curves. Results From the baseline of 1487 patients, 20.9% (n = 311) experienced Bell’s palsy onset by the end of the study. In univariate analysis, male gender (RR = 2.1 95% CI 1.7–2.5; P < 0.0001), age less than 30 years (RR = 2.9 95% CI 2.4–3.6; P < 0.0001), HIV seropositivity (RR =2.9 95% CI 2.3–4.9; P < 0.0001). The highest incidence in winter (30.3% n = 136/450) vs. incidences during other seasons with Intermediate values during Summer (25.3% n = 136/450) and Autumn (20.7% n = 64/308) and the lowest incidence in Spring (23.7% n = 16/353) P < 0.0001) were predictors of Bell’s palsy. In multivariate analysis at adjusting for gender, the most significant and independent predictors of incident Bell’s palsy were HIV seropositivity (HR = 6.3 95% CI 4.8–8.3; P < 0.0001), winter (HR = 1.6 95% CI 1.2–2.1; P < 0.0001) vs. other seasons, and younger age < 30 years (HR = 7.1 95% CI 5.6–9.1; P < 0.0001) vs. older age groups. Conclusion Seasonality, younger age and HIV positivity are important and independent risk factors of Bell’s palsy. Education and awareness programs on the possible effects of HIV and seasons on the development of Bell’s palsy are necessary. This would lead to a better understanding and even a possible development of avoidance measures for this condition amongst young black South Africans.

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Distal Sensory Peripheral Neuropathy in Human Immunodeficiency Virus Type 1–Positive Individuals Before and After Antiretroviral Therapy Initiation in Diverse Resource-Limited Settings

Vecchio

Marra

Jiang

et al. 2019

Clinical Infectious Diseases

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Background Distal sensory peripheral neuropathy (DSPN) is a complication of human immunodeficiency virus (HIV). We estimate DSPN prevalence in 7 resource-limited settings (RLSs) for combination antiretroviral therapy (cART)–naive people living with HIV (PLWH) compared with matched participants not living with HIV and in PLWH virally suppressed on 1 of 3 cART regimens. Methods PLWH with a CD4+ count <300 cells/mm3 underwent standardized neurological examination and functional status assessments before and every 24 weeks after starting cART. Matched individuals not living with HIV underwent the same examinations once. Associations between covariates with DSPN at entry were assessed using the χ2 test, and virally suppressed PLWH were assessed using generalized estimating equations. Results Before initiating cART, 21.3% of PLWH had DSPN compared with 8.5% of people not living with HIV (n = 2400; χ2(df = 1) = 96.5; P < .00001). PLWH with DSPN were more likely to report inability to work [χ2(df = 1) = 10.6; P = .001] and depression [χ2(df = 1) = 8.9; P = .003] than PLWH without DSPN. Overall prevalence of DSPN among those virally suppressed on cART decreased: 20.3%, week 48; 15.3%, week 144; and 10.3%, week 192. Incident DSPN was seen in 127 PLWH. Longitudinally, DSPN was more likely in older individuals (P < .001) and PLWH with less education (P = .03). There was no significant association between cART regimen and DSPN. Conclusions Although the prevalence of DSPN decreased following cART initiation in PLWH, further research could identify strategies to prevent or ameliorate residual DSPN after initiating cART in RLSs.

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HIV-Associated Polyneuropathy in Resource-Limited Settings: Genetic Predisposition and Vitamin Variations

Cited by 4 publications

References 79 publications

Nutritional and health status of people living with HIV/AIDS in the eastern region of Ghana

Nutritional and health status of people living with HIV/AIDS in the eastern region of Ghana

HIV infection, seasonality and younger age predicting incident Bell’s palsy among black South Africans

Distal Sensory Peripheral Neuropathy in Human Immunodeficiency Virus Type 1–Positive Individuals Before and After Antiretroviral Therapy Initiation in Diverse Resource-Limited Settings

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