Tuberculosis, human immunodeficiency virus infection, and malnutrition in Burundi

Niyongabo, T; Henzel, D.; Idi, Mwanasumba; Nimubona, Stanislas; Gikoro, E.; Melchior, J.C.; Matheron, Sophie; Kamanfu, G; Samb, Badara; Messing, Bernard; Bégué, Jean-Marc; Aubry, P; Larouzé, Bernard

doi:10.1016/s0899-9007(99)00003-9

Cited by 38 publications

(31 citation statements)

References 18 publications

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“…Consistent with previous reports from Burundi (Niyongabo et al, 1999), Uganda (Shah et al, 2001), and Haiti (Scalcini et al, 1991), albumin concentrations were inversely related to HIV infection in our study. Although these results suggest that hypoalbuminemia is a frequent finding among HIV/TB coinfected adults, its usefulness as an indicator of poor nutritional status is questionable in persons with severe infections since concentrations can be downregulated by cytokines IL-1 and IL-6 during the acute phase response.…”

Section: Discussionsupporting

confidence: 93%

“…Results on the additional impact of HIV on wasting at these low levels of fat percent in TB-infected subjects are inconsistent. HIV infection was related to lower BMI in some (Niyongabo et al, 1994(Niyongabo et al, , 1999Kennedy et al, 1996) but not all (Shah et al, 2001;Madebo et al, 2003;Van Lettow et al, 2004) these previous studies. We did not find associations between HIV and anthropometric indicators of FM such as BMI or TSF; however, we found that HIV infection was associated with decreased indicators of lean mass such as the AMC, in both men and women.…”

Section: Discussionmentioning

confidence: 84%

“…This question was addressed in anthropometric studies that yielded inconsistent results. While HIV infection was related to decreased BMI among TB-infected adults from Burundi (Niyongabo et al, 1994(Niyongabo et al, , 1999 and Tanzania (Kennedy et al, 1996), no association was found in Uganda (Shah et al, 2001), Ethiopia (Madebo et al, 2003) or Malawi (Van Lettow et al, 2004). The majority of these studies failed to adjust the association between HIV infection and wasting for the potential confounding effects of socioeconomic characteristics and the severity of TB infection.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, lean mass of TB-infected adults may increase after nutritional supplementation (Paton et al, 2004). A few cross-sectional studies examined the impact of HIV infection on body composition of adults with TB and yielded divergent results; BCM was found to be lower in coinfected men from Malawi (Van Lettow et al, 2004), but not in patients from Uganda (Shah et al, 2001) or Burundi (Niyongabo et al, 1994(Niyongabo et al, , 1999. In Malawi and Uganda, HIV coinfection was related to decreased phase angle, an indicator of cell membrane integrity that has been reported to be predictive of mortality (Ott et al, 1995;Schwenk et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

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Wasting and body composition of adults with pulmonary tuberculosis in relation to HIV-1 coinfection, socioeconomic status, and severity of tuberculosis

et al. 2005

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Objective: To examine the impact of HIV coinfection, socioeconomic status (SES) and severity of tuberculosis (TB) on the body composition and anthropometric status of adults with pulmonary TB. Design: Cross-sectional study. Setting: Five TB clinics in Dar es Salaam, Tanzania. Subjects: A total of 2231 adult men and women diagnosed with pulmonary TB, prior to the initiation of anti-TB therapy. Methods: We compared the distribution of anthropometric characteristics including body mass index (BMI), mid-upper arm circumference (MUAC), triceps skin-fold (TSF), and arm muscle circumference (AMC) by HIV status, SES characteristics, and indicators of TB severity (bacillary density in sputum and Karnofsky performance score). Similar comparisons were carried out with body composition variables from bioelectrical impedance analysis and albumin concentrations, in a subsample of 731 subjects. Results: In multivariate analysis, HIV infection was significantly associated with lower MUAC and AMC in both men and women, but not with BMI or TSF. Compared to HIV-uninfected women, those who were HIV infected had lower body cell mass (BCM) (adjusted difference ¼ À0.85 kg, P ¼ 0.04), intracellular water (À0.68 l, P ¼ 0.04), and phase angle (À0.52, P ¼ 0.02). Albumin concentrations were significantly lower in both men and women infected with HIV. Among HIV-infected men, CD4 cell counts o200/mm 3 were related to lower intracellular water, BCM, fat-free mass and phase angle. Independent of HIV infection, BMI and MUAC were positively related to SES indicators and the Karnofsky performance score; and inversely related to bacillary density. Conclusions: HIV infection is associated with indicators of low lean body mass in adults with TB; socioeconomic factors and TB severity are important correlates of wasting, independent of HIV. Sponsorship: The National Institute of Allergy and Infectious Diseases (UO1 AI 45441-01).

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Wasting and body composition of adults with pulmonary tuberculosis in relation to HIV-1 coinfection, socioeconomic status, and severity of tuberculosis

et al. 2005

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“…TB and HIV infection frequently occur together and can result in severe wasting (Niyongabo et al, 1999a;Lettow van et al, 2004). The wasting, in turn, affects the inflammatory response, suppresses cellular immunity, and aggravates the severity and outcome of disease (Shears, 1991).…”

Section: Introductionmentioning

confidence: 99%

Alterations in serum levels of trace elements in tuberculosis and HIV infections

et al. 2005

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Objective: To evaluate serum concentrations of trace elements in tuberculosis (TB) patients with or with out human immunodeficiency virus (HIV) coinfection before and after anti-TB chemotherapy. Subjects: A total of 155 TB patients, 74 of which were coinfected with HIV, and 31 healthy controls from Gondar, Ethiopia. Methods: Serum levels of copper, zinc, selenium and iron were determined using an inductively coupled plasma mass spectrometer from all subjects at baseline and from 44 TB patients (22 with HIV coinfection) at the end of an intensive phase of anti-TB chemotherapy. Results: Compared with the control group, the concentrations of iron, zinc and selenium were significantly lower (Po0.05) while that of copper and copper/zinc ratio was significantly higher (Po0.05) in the serum of TB patients. TB patients with HIV coinfection had significantly lower serum zinc and selenium concentrations and significantly higher copper/zinc ratio compared to that in TB patients without HIV coinfection (Po0.05). The serum concentration of zinc had significantly increased at the end of intensive phase of anti-TB chemotherapy in patients without HIV coinfection (Po0.05). An increase in serum selenium level was observed in TB patients with or without HIV coinfection after therapy. On the contrary, serum copper concentration and copper/zinc ratio declined significantly after anti-TB chemotherapy irrespective of HIV serostatus (Po0.05). Conclusions:The results indicate that TB patients have altered profile of trace elements in their sera. This warrants the need for further investigations so that strategies for trace elements supplementation can be planned in addition to their potential as diagnostic parameters in monitoring responses to anti-TB chemotherapy.

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HIV and Nutrition

Sztam

Ndirangu

2009

Preventive Nutrition

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Tuberculosis, human immunodeficiency virus infection, and malnutrition in Burundi

Cited by 38 publications

References 18 publications

Wasting and body composition of adults with pulmonary tuberculosis in relation to HIV-1 coinfection, socioeconomic status, and severity of tuberculosis

Wasting and body composition of adults with pulmonary tuberculosis in relation to HIV-1 coinfection, socioeconomic status, and severity of tuberculosis

Alterations in serum levels of trace elements in tuberculosis and HIV infections

HIV and Nutrition

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