Family Nutritional Support Improves Survival, Immune Restoration and Adherence in HIV Patients Receiving ART in Developing Country

家庭營養支持改善發展中國家接受抗逆轉錄病毒治療的愛滋病人其存活、免疫修復及依附

Charlotte Serrano ； Remi Laporte ； Moussa Ide ； Yacouba Nouhou ； Pierre de Truchis ； Elisabeth Rouveix ； Adiza Adamou ； Vanessa Pauly ； Jean-François Mattei ； Jean-Albert Gastaut

《Asia Pacific Journal of Clinical Nutrition》 19卷1期 (2010/03) Pp. 68-75

https://doi.org/10.6133/apjcn.2010.19.1.09

摘要

In developing countries, access to antiretroviral treatment for persons living with HIV is still in progress. Malnutrition represents another cause of acquired immunodeficiency and premature death. This evaluation program estimated the impact of family nutritional support during the first year of antiretroviral treatment in West Africa's sub-Sahara region. Family nutritional support was proposed to patients with CD-4 cell count ＜200 /mm^3 and/or developing a WHO stage III/IV or with body mass index ＜18.5 kg/m^2 and receiving antiretroviral treatment. Follow- up of 62 patients receiving support was compared to 118 patients who had only received antiretroviral treatment the year before. Average body mass index, CD-4 cell count were 20.7 and 20.5, 217 and 191/mm^3 respectively in supported and control groups (NS). Twenty-two (36%) and 56 (48%) were WHO stage III/IV (NS) respectively in supported and control groups. One patient who received support and twelve controls died (Mortality Ratio=0.19; p＜0.05). Increase in CD-4 cell count was around 1.7 times higher (+ 114 vs. + 68 CD-4 cells/mm^3 respectively in supported and control groups; p＜0.05) and observance was improved in supported group (p＜0.005). The evolutions of WHO stage and body mass index were not different but the study period was short. Family nutritional support for persons living with HIV initiating antiretroviral treatment in a developing country showed a positive impact after six months. This family intervention could be integrated into AIDS interventions as an effective and comprehensive community-based primary care.

關鍵字

後天免疫缺乏症候群 ； 發展中國家 ； 營養支持 ； 存活 ； 免疫修復

並列摘要

In developing countries, access to antiretroviral treatment for persons living with HIV is still in progress. Malnutrition represents another cause of acquired immunodeficiency and premature death. This evaluation program estimated the impact of family nutritional support during the first year of antiretroviral treatment in West Africa's sub-Sahara region. Family nutritional support was proposed to patients with CD-4 cell count ＜200 /mm^3 and/or developing a WHO stage III/IV or with body mass index ＜18.5 kg/m^2 and receiving antiretroviral treatment. Follow- up of 62 patients receiving support was compared to 118 patients who had only received antiretroviral treatment the year before. Average body mass index, CD-4 cell count were 20.7 and 20.5, 217 and 191/mm^3 respectively in supported and control groups (NS). Twenty-two (36%) and 56 (48%) were WHO stage III/IV (NS) respectively in supported and control groups. One patient who received support and twelve controls died (Mortality Ratio=0.19; p＜0.05). Increase in CD-4 cell count was around 1.7 times higher (+ 114 vs. + 68 CD-4 cells/mm^3 respectively in supported and control groups; p＜0.05) and observance was improved in supported group (p＜0.005). The evolutions of WHO stage and body mass index were not different but the study period was short. Family nutritional support for persons living with HIV initiating antiretroviral treatment in a developing country showed a positive impact after six months. This family intervention could be integrated into AIDS interventions as an effective and comprehensive community-based primary care.

並列關鍵字

AIDS ； developing country ； nutritional support ； survival ； immunologic restoration