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Malnutrition and lipid abnormalities in antiretroviral naïve HIV-infected adults in Addis Ababa: A cross-sectional study

BACKGROUND: Both under- and over-nutrition may occur among human immunodeficiency virus (HIV)-infected individuals and impact on the course of the acquired immune deficiency syndrome (AIDS) and its management due to the close interaction between immunity and nutrition. We investigated occurrence of...

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Autores principales: Adal, Melaku, Howe, Rawleigh, Kassa, Desta, Aseffa, Abraham, Petros, Beyene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5908150/
https://www.ncbi.nlm.nih.gov/pubmed/29672576
http://dx.doi.org/10.1371/journal.pone.0195942
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author Adal, Melaku
Howe, Rawleigh
Kassa, Desta
Aseffa, Abraham
Petros, Beyene
author_facet Adal, Melaku
Howe, Rawleigh
Kassa, Desta
Aseffa, Abraham
Petros, Beyene
author_sort Adal, Melaku
collection PubMed
description BACKGROUND: Both under- and over-nutrition may occur among human immunodeficiency virus (HIV)-infected individuals and impact on the course of the acquired immune deficiency syndrome (AIDS) and its management due to the close interaction between immunity and nutrition. We investigated occurrence of undernutrition, excess weight and lipid abnormalities among antiretroviral naïve HIV-infected adults in Addis Ababa, Ethiopia. METHODS: A cross-sectional study on 594 antiretroviral therapy (ART) naïve HIV-infected adults was conducted in four hospitals in Addis Ababa from February to September 2013. Hematological parameters (CD4+ T cell count and hemoglobin concentration), fasting serum glucose, total cholesterol (TC) and triglycerides (TG) were determined. Information on socio-demographic, anthropometric and World Health Organization (WHO) clinical stages was collected from patient clinical records, and triangulated by structured questionnaire. Height and weight measurements were taken and body mass index (BMI), undernutrition (BMI <18.5 kg/m(2)) and excess weight (BMI ≥25 kg/m(2)) determined. Statistical comparisons were made to identify significant factors associated with nutritional status and lipid profiles. RESULTS: The prevalence of undernutrition was 15.1%, and the prevalence of excess weight was 22.1%, including 5.4% who were obese. The prevalence of hypercholesterolemia was 16.6% and it was higher in women (18.9%) than in men (11.0%) (p<0.05). However, the prevalence of hypertriglyceridemia was 29.8%. There was significant positive Spearman correlation between CD4+ T cell count and serum TC (r = 0.210, p<0.001), but no correlation was observed between CD4+ T cell count and TG (r = -0.007, p>0.05). Age categories 30–39 and 40–79, and WHO clinical stages III/IV for undernutrition; age categories 30–39 and 40–79, WHO clinical stages III/IV and TC ≥200 mg/dL for excess weight; and being female, age categories 30–39 and 40–79, and hypertriglyceridemia for hypercholesterolemia were found to be independent predictors by binomial logistic regression analysis. CONCLUSION: Undernutrition, excess weight, hypercholesterolemia and hypertriglyceridemia were variably prevalent in ART naïve HIV-infected populations. This emphasizes the need for targeted nutritional programs as an integral part of HIV/AIDS care. Lipid levels need to be monitored regularly in patients whether on or off ART. In addition, improvement on household income and positive change in lifestyle and/or nutritional treatment to reduce morbidity and mortality are necessary interventions in HIV/AIDs patient management.
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spelling pubmed-59081502018-05-04 Malnutrition and lipid abnormalities in antiretroviral naïve HIV-infected adults in Addis Ababa: A cross-sectional study Adal, Melaku Howe, Rawleigh Kassa, Desta Aseffa, Abraham Petros, Beyene PLoS One Research Article BACKGROUND: Both under- and over-nutrition may occur among human immunodeficiency virus (HIV)-infected individuals and impact on the course of the acquired immune deficiency syndrome (AIDS) and its management due to the close interaction between immunity and nutrition. We investigated occurrence of undernutrition, excess weight and lipid abnormalities among antiretroviral naïve HIV-infected adults in Addis Ababa, Ethiopia. METHODS: A cross-sectional study on 594 antiretroviral therapy (ART) naïve HIV-infected adults was conducted in four hospitals in Addis Ababa from February to September 2013. Hematological parameters (CD4+ T cell count and hemoglobin concentration), fasting serum glucose, total cholesterol (TC) and triglycerides (TG) were determined. Information on socio-demographic, anthropometric and World Health Organization (WHO) clinical stages was collected from patient clinical records, and triangulated by structured questionnaire. Height and weight measurements were taken and body mass index (BMI), undernutrition (BMI <18.5 kg/m(2)) and excess weight (BMI ≥25 kg/m(2)) determined. Statistical comparisons were made to identify significant factors associated with nutritional status and lipid profiles. RESULTS: The prevalence of undernutrition was 15.1%, and the prevalence of excess weight was 22.1%, including 5.4% who were obese. The prevalence of hypercholesterolemia was 16.6% and it was higher in women (18.9%) than in men (11.0%) (p<0.05). However, the prevalence of hypertriglyceridemia was 29.8%. There was significant positive Spearman correlation between CD4+ T cell count and serum TC (r = 0.210, p<0.001), but no correlation was observed between CD4+ T cell count and TG (r = -0.007, p>0.05). Age categories 30–39 and 40–79, and WHO clinical stages III/IV for undernutrition; age categories 30–39 and 40–79, WHO clinical stages III/IV and TC ≥200 mg/dL for excess weight; and being female, age categories 30–39 and 40–79, and hypertriglyceridemia for hypercholesterolemia were found to be independent predictors by binomial logistic regression analysis. CONCLUSION: Undernutrition, excess weight, hypercholesterolemia and hypertriglyceridemia were variably prevalent in ART naïve HIV-infected populations. This emphasizes the need for targeted nutritional programs as an integral part of HIV/AIDS care. Lipid levels need to be monitored regularly in patients whether on or off ART. In addition, improvement on household income and positive change in lifestyle and/or nutritional treatment to reduce morbidity and mortality are necessary interventions in HIV/AIDs patient management. Public Library of Science 2018-04-19 /pmc/articles/PMC5908150/ /pubmed/29672576 http://dx.doi.org/10.1371/journal.pone.0195942 Text en © 2018 Adal et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Adal, Melaku
Howe, Rawleigh
Kassa, Desta
Aseffa, Abraham
Petros, Beyene
Malnutrition and lipid abnormalities in antiretroviral naïve HIV-infected adults in Addis Ababa: A cross-sectional study
title Malnutrition and lipid abnormalities in antiretroviral naïve HIV-infected adults in Addis Ababa: A cross-sectional study
title_full Malnutrition and lipid abnormalities in antiretroviral naïve HIV-infected adults in Addis Ababa: A cross-sectional study
title_fullStr Malnutrition and lipid abnormalities in antiretroviral naïve HIV-infected adults in Addis Ababa: A cross-sectional study
title_full_unstemmed Malnutrition and lipid abnormalities in antiretroviral naïve HIV-infected adults in Addis Ababa: A cross-sectional study
title_short Malnutrition and lipid abnormalities in antiretroviral naïve HIV-infected adults in Addis Ababa: A cross-sectional study
title_sort malnutrition and lipid abnormalities in antiretroviral naïve hiv-infected adults in addis ababa: a cross-sectional study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5908150/
https://www.ncbi.nlm.nih.gov/pubmed/29672576
http://dx.doi.org/10.1371/journal.pone.0195942
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