<p>Prevalence Of Undernutrition And Associated Factors Among Adults Receiving First-Line Antiretroviral Treatment In Public Health Facilities Of Arba Minch Town, Southern Ethiopia</p>

Abstract

IntroductionAccess to antiretroviral drugs for all infected persons in need is a global health priority. The primary goals of initiating antiretroviral drugs are to suppress human immunodeficiency virus viral replication and to restore immune function. However, adequate nutrition is necessary to manage opportunistic infections and to maintain the immune system. Therefore, this study aimed to determine the recent prevalence of undernutrition and associated factors among HIV patients receiving first-line antiretroviral therapy in public health facilities of Arba Minch town, Gamo zone, Southern Ethiopia.MethodsInstitution-based cross-sectional study was used among 333 adult patients receiving first-line antiretroviral therapy at public health facilities of Arba Minch town. A simple random sampling technique was used to select the study subjects. Data were collected through interviewer-administered questionnaires. Binary and multivariable logistic regression analyses were used to identify factors associated with undernutrition. A p-value <0.05 with a 95% confidence level was used to declare statistical significance.ResultsThe overall prevalence of undernutrition among adult patients receiving first-line antiretroviral therapy is 23.72% (95% CI: 19.13–28.27%). Current substance use (AOR=1.83, 95% CI:1.09–3.08), duration on antiretroviral therapy (AOR=1.87, 95% CI:1.06–3.30), not taking cotrimoxazole preventive therapy (AOR=2.09, 95% CI:1.15–3.82), advanced WHO clinical stages (AOR=5.1, 95% CI: 2.9–7.7), CD4 count less than 350 cell/mm3 (AOR=1.83, 95% CI: 1.09–3.05) and active tuberculosis (AOR=1.89, 95% CI: 1.02–3.53) were factors significantly associated with undernutrition among respondents who were enrolled on first-line antiretroviral therapy.ConclusionThis study shows that the prevalence of undernutrition was high among adult patients on first-line antiretroviral therapy. Therefore, this finding shows the need to implement nutrition programs to improve the nutritional status of adults living with HIV in the study area. The interventions should emphasise those patients who use the substance, who are in advanced WHO clinical stage and have active tuberculosis. Besides, emphasis should be given for patients to undertake cotrimoxazole preventive therapy and to regularly follow their CD4 count.

The Nutritional Status of Adult Antiretroviral Therapy Recipients with a Recent HIV Diagnosis; A Cross-Sectional Study in Primary Health Facilities in Gauteng, South Africa

“…This study found a higher prevalence of undernutrition in those who were on ART for a shorter duration (15%) than those who had been on ART for a longer duration (11%), although the association was not significant. This observation is supported by findings from other studies, in which those who had been on ART for a short duration were almost twice as undernourished as those who had been taking the ART for a longer duration [11,44]. The explanation for this observation could be that patients who are undernourished at the time of their enrolment on ART, who might have been suffering from a more advanced stage of the disease, become healthier and gain weight over time, with their recovery from opportunistic infections [41,45].…”

Undernutrition and associated factors among adult HIV/AIDS patients receiving antiretroviral therapy in eastern zone of Tigray, Northern Ethiopia: a cross-sectional study

“…Participants with CD4+ < 200 cell/μl had 1.84 times chance of being undernourished compared to those with CD4+ cells/μl count > 500 (AOR = 1.84; 95% CI: 1-3.36). Other studies done in Ethiopia [19,21,23,24] showed similar associations. This result is also in line with other studies done in developed and developing countries [10,[38][39][40].…”

“…But this is higher than other studies done in Tanzania (19%) [15] and Zimbabwe (10%) [16]. Similarly, it is also higher than other studies done in Ethiopia such as in Arba Minch Town (23.2%) [21], 12.3% in Dilla University [19], and 23.2% in Dembia district [23]. This different result among different studies could be explained by the discrepancy in health care awareness of the community and the sample size difference.…”

“…Ethiopia is also one of the countries hit hardest by the HIV epidemic alongside malnutrition [17]. The prevalence of undernutrition among HIV/AIDS patients receiving ART in Ethiopia ranges from 12.3 to 46.8% [18][19][20][21][22][23][24].…”

Regulation of Gut Microbiota on Immune Reconstitution in Patients With Acquired Immunodeficiency Syndrome

“…Further analysis revealed that CD4 + T cell counts below 350 or 200 cells/μl were significantly associated with malnutrition. In the case of malnutrition, changes in the levels of immune cell populations, hormones, and cytokines lead to changes in the metabolism of immune cells, thereby affecting immune function (Oumer et al, 2019). During the whole process of HIV infection, nutritional status and immune function are closely related and interact.…”