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

ABSTRACT: 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.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/m2) and excess weight (BMI ?25 kg/m2) determined. Statistical comparisons were made to identify significant factors associated with nutritional status and lipid profiles.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.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.

SUBMITTER: Adal M

PROVIDER: S-EPMC5908150 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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

Adal Melaku M Howe Rawleigh R Kassa Desta D Aseffa Abraham A Petros Beyene B

PloS one 20180419 4

<h4>Background</h4>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.<h4>Methods</h4>A cross-sectional study on 594 antiretroviral thera ...[more]

PMID: 29672576

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Project description:BACKGROUND:In Ethiopia, malnutrition among older adults is under detected and, neglected area because the entire problem related with aging considered as fate of aging. Also, older adults are often omitted from public health research. Literatures are scarce in Ethiopia; there is limited information in the current study area among older adults using Min Nutritional Assessment (MNA). Therefore, this paper investigated the prevalence of malnutrition and its predictors among older adults people aged 65?years or above in Addis Ababa, Ethiopia. METHODS:A community-based cross-sectional study was employed from January 1 to march 30, 2020 in Addis Ababa. Nutritional status of the older adults was measured by using Min nutritional assessment (MNA). Data from 662 older adults were collected through face to face interviews using a structured questionnaire. Bivariable and multivariable logistic regression analysis was done to identify factors associated with malnutrition. RESULT:The prevalence of malnutrition among older adults was found to be 26.6%[95% Confidence interval (CI):22.8, 30.1]. Depression [Adjusted Odds Ratio (AOR)?=?7.57 95%CI: 5.01, 11.45], being poor [AOR?=?1.95 95% CI: 1.166, 3.25], occupation; daily laborer and guard [AOR?=?2.78 95% CI: 1.12, 7.17] and being old old [AOR?=?2.62 95% CI: 1.62, 4.25] were significantly associated with the higher odds of malnutrition. CONCLUSION:This study illustrated that considerably high proportion of older adults were malnourished in Addis Ababa. Socio-economic characteristics and depression were significantly associated with malnutrition. Therefore, nutritional and social support activities are essential for older adults, particularly of those who are socio-economically disadvantaged and advanced age. In addition, regular nutritional screening and management as well as behavioral interventions should be strengthened as a pillar component of therapeutic interventions. Specific nutritional requirements, at later stages of life is changing, and with the population aged over 65?years increasing in low-income countries like Ethiopia, the research in this field is likely to increase further.

Project description:BackgroundData on the prevalence of renal and urine abnormalities among HIV-infected children in Sub-Saharan Africa are limited. We set out to determine the prevalence of proteinuria; low estimated glomerular filtration rate (eGFR), urinary tract infection and associated factors among HIV-infected antiretroviral therapy (ART) naive children, aged 2-12 years, attending the paediatric HIV clinic at a tertiary hospital in Harare.MethodsConsecutive ART naive children attending the clinic between June and October 2009 were recruited. Detailed medical history was obtained and a complete physical examination was performed. Children were screened for urinary tract infection and for significant persistent proteinuria. Serum creatinine was used to estimate GFR using the modified Counahan-Barratt formula. The Student's t-test was used to analyse continuous variables and the chi-square or Fisher's exact test was used to analyse categorical data. Logistic regression was performed to assess the relationship between study factors and urine abnormalities, persistent proteinuria and the eGFR.ResultsTwo hundred and twenty children were enrolled into the study. The median age was 90 months (Q1=65.5; Q3=116.5). The prevalence of urinary tract infection was 9.5%. Escherichia coli was the predominant organism. There was uniform resistance to cotrimoxazole. Persistent proteinuria (urine protein to creatinine ratio greater than 0.2, a week apart) was found in 5% of the children. Seventy-five children (34.6%) had mild to moderate renal impairment shown by a low eGFR (30 to <90 ml/min/1.73 m2). Persistent proteinuria was more likely to be found in children who were wasted, weight-for-height (WHZ) z-score <-2 (p=0.0005). Children with WHO clinical stage 4 were more likely to have a low eGFR than children with less advanced stages (OR 2.68; CI 1.24-5.80). Urine abnormalities were more likely to be observed in children with WHO clinical stages 3 and 4 (OR 2.20; CI 1.06-4.60).ConclusionThere is significant renal impairment among HIV-infected, ART naive children aged 2-12 years attending the outpatient paediatric HIV clinic at Harare Central Hospital. The abnormalities are more likely to occur in children with advanced HIV/AIDS. Screening for renal impairment and urinary tract infections in HIV-infected children before initiation of ART and regularly thereafter would be helpful in their management.KeywordsHIV, renal disease, persistent proteinuria, glomerular filtration rate, urinary tract infection.

Project description:Males are more susceptible than females to infections due to the differences in endocrine-immune interactions. Furthermore, it is reported that lowering cell cholesterol impairs viral replication and infection in vitro. However, the production of oxysterols in vivo by oxidation of cholesterol may result in inhibition of HIV replication. Therefore, this study was designed to determine the associations of gender and serum total cholesterol with CD4+ T cell counts and/or WHO clinical stages, and HIV ribonucleic acid (RNA) load in antiretroviral therapy (ART) naive study population with known sero-positive time of stay in Addis Ababa. METHODS: A cross-sectional study was conducted from February to August 2013 on 594 HIV-1 infected ART-naïve adult study participants in four hospitals Addis Ababa. CD4+ T-cell count, HIV RNA load, hemoglobin and fasting serum total cholesterol were determined. Socio-demographic characteristics, WHO clinical stages, and height and weight were collected from patients' chart and triangulated by structured questionnaire. Pearson chi-square test, Spearman rank correlation and univariate and multivariate linear/logistic regression analyses were carried out to determine associations.Mean HIV RNA load was found to be lower in women than in men (p?<?0.05). CD4+ T cell count and serum total cholesterol were found to be significantly correlated with HIV RNA load (p?<?0.01). Women were at lower risk of having higher HIV RNA load in comparison to men. In addition, having lower concentrations of serum total cholesterol was found to be independent predictor of higher HIV RNA load in comparison to those with higher concentrations of cholesterol in serum (p?<?0.05). The multivariate binomial logistic regression also showed that the immune status was better in women than men, and in the presence of higher serum total cholesterol (p?<?0.05).Gender and serum total cholesterol were found to be associated and independent predictors of HIV RNA load, and CD4+ cell count and/or WHO clinical stages. There is a significant lower HIV RNA load and better CD4+ T cell count in women and those study participants with higher serum total cholesterol.

Project description:BACKGROUND:Sexual behavior of HIV positive individuals visiting anti- retroviral clinics is a neglected issue. With access to anti-retroviral treatment, HIV positive individuals experience improved health and are able to reintegrate into their social life and many of them engage in sexual activities. In the context of Ethiopia, safer sex practices among people living with HIV is critical in terms of preventing the acquisition of another strain of HIV and helping address the epidemic. METHOD:An institution-based cross sectional study was conducted at Addis Ababa public hospitals from January to February 2017. A pretested structured questionnaire was used to collect the data. Using the systematic random sampling technique, a total of 562 respondents participated in the study. The data were entered into EPI info version 3.5.3 and transferred to SPSS version 20 for analysis. Descriptive statistics, bi-variate, and multi variable analyses were done. A p-value <?0.05 was considered to determine the statistical significance of the association between factors (independent variables) and risky sexual practice. The Odds ratio was also used to determine the presence and the degree of association between dependent and independent variables. RESULTS:A total of 562 respondents participated in the study which revealed that the prevalence of risky sexual practice was 39.1% (95% CI: 35.2, 43.8) three months prior to the data collection. Educational status of participants who were below grade eight (AOR?=?2.27, 95% CI:1.01,5.10) and went to grades eight to twelve (AOR?=?2.12, 95% CI:1.02,4.41), were married (AOR?=?2.07, 95% CI:1.06,4.02), had no concern for safer sexual practice (AOR?=?3.74, 95% CI:2.28, 6.13), had CD4 count of ?500cells/mm3(AOR?=?1.66, 95% CI:1.04, 2.64), and used substance (AOR?=?3.41, 95% CI:1.83, 6.35) were significantly associated with risky sexual practice. CONCLUSION:The prevalence of risky sexual practice was markedly high in this study due to such contributory factors as low educational status, marriage, lack of concern for safer sexual practices, and substance use.

Project description:Background:Hematological abnormalities are common in HIV positive patients. Of these, thrombocytopenia is a known complication which has been associated with a variety of bleeding disorders. However, its magnitude and related factors have not been well-characterized in the era of highly active antiretroviral therapy (HAART) in Ethiopia. Therefore, this study aimed to assess the prevalence of thrombocytopenia before and after initiation of HAART among HIV positive patients attending Black Lion Specialized Hospital, Addis Ababa, Ethiopia. Methods:A cross sectional study was conducted from February to April 2017 in Black Lion Specialized Hospital, Addis Ababa, Ethiopia. A total of 176 patients on HAART were selected using simple random sampling techniques. Socio-demographic and clinical characteristics of the study patients were collected using structured questionnaire. Measurements of platelet counts and CD4 + T cell counts were made using Sysmex XT 2000i hematology analyzer and BD FACS Count CD4 analyzer, respectively. Statistical analysis of the data (Paired T- test and binary logistic regression) was done using SPSS version 20. P-value < 0.05 was considered as statistically significant. Results:A total of 176 patients (Age > 18 years old) were enrolled in this study and had a mean age of 40.08 ± 9.38 years. There was significant increase in the mean values of platelet counts (218.44 ± 106.6 × 103/μl vs 273.65 ± 83.8 × 103/μl, p < 0.001) after six months of HAART initiation compared to the baseline. Prevalence of thrombocytopenia before and after HAART initiation was 25 and 5.7% respectively. HIV patients whose CD4 counts < 200 Cells/μl were more likely to have thrombocytopenia than HIV patients whose CD4 count ≥350 Cells/μl. However, it was not statistically associated with prevalence of thrombocytopenia. Conclusions:This study has shown that the prevalence of thrombocytopenia after HAART initiation was decreased significantly. Based on our results, a number of study participants still had thrombocytopenia after initiation of HAART. Therefore, continuous screening for thrombocytopenia among HIV infected patients should be performed to decrease the risk of morbidity and mortality.

Dataset Information

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

Publications

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

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