Nutritional status and CD4 cell counts in patients with HIV/AIDS receiving antiretroviral therapy

Abstract

Introduction: Even with current highly active antiretroviral therapy, individuals with AIDS continue to exhibit important nutritional defi cits and reduced levels of albumin and hemoglobin, which may be directly related to their cluster of differentiation 4 (CD4) cell counts. The aim of this study was to characterize the nutritional status of individuals with human immunodefi ciency virus/acquired immunodefi ciency syndrome (HIV/AIDS) and relate the fi ndings to the albumin level, hemoglobin level and CD4 cell count. Methods: Patients over 20 years of age with AIDS who were hospitalized in a university hospital and were receiving antiretroviral therapy were studied with regard to clinical, anthropometric, biochemical and sociodemographic characteristics. Body mass index, percentage of weight loss, arm circumference, triceps skinfold and arm muscle circumference were analyzed. Data on albumin, hemoglobin, hematocrit and CD4 cell count were obtained from patient charts. Statistical analysis was performed using Fisher's exact test, Student's t-test for independent variables and the Mann-Whitney U-test. The level of signifi cance was set to 0.05 (α = 5%). Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) 17.0 software for Windows. Results: Of the 50 patients evaluated, 70% were male. The prevalence of malnutrition was higher when the defi nition was based on arm circumference and triceps skinfold measurement. The concentrations of all biochemical variables were signifi cantly lower among patients with a body mass index of less than 18.5kg/m². The CD4 cell count, albumin, hemoglobin and hematocrit anthropometric measures were directly related to each other. Conclusions: These fi ndings underscore the importance of nutritional follow-up for underweight patients with AIDS, as nutritional status proved to be related to important biochemical alterations.

Nutritional Status and CD4 Cell Counts in HIV/AIDS Patients under Highly Active Antiretroviral Therapy in Addis Ababa, Ethiopia

“…According to the Joint United Nations Program on HIV/AIDS (UNAIDS) report in sub-Saharan Africa six in 10 adults living with HIV are currently woman [1]. The present study was also in agreement with the UNAIDS report.…”

“…Many studies showed the introduction of HAART greatly improved the life expectancy and quality of life; however malnutrition is still a concern [1,6]. Despite this fact, there was no any statistically significant association between CD4 cell count and the malnutrition indicators used in this study.…”

“…Antiretroviral therapy increases CD4 lymphocyte counts, reduce risk of opportunistic infections and improve survival of HIV infected people [1]. Before a widespread of ART, malnutrition was seriously associated with the diminished life expectancy [2,3].…”

“…The HAART regimens comprise nucleoside-analog reverse transcriptase inhibitors (NRTIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs) and entry inhibitors [7]. Although HAART improved the life expectancy of HIV infected people, malnutrition is still a concern [1]. Malnutrition is associated with repeated opportunistic infections, rapid disease progression, and increase in the incidence of HIV-related mortality [8].…”

“…In patients with HIV, there is an association among low albumin levels, low body mass index (BMI) and CD4 count<200 cells/mm³ [1]. The Nutritional status of HIV/AIDS patients and HIV disease progression association should be thoroughly investigated for developing strategies to diminish mortality of HAART taking HIV/AIDS patients.…”