2013, Number 4
<< Back Next >>
Rev Invest Clin 2013; 65 (4)
Nutritional care, time period since diagnosis, demographics and body mass index in HIV/AIDS patients
Núñez-Rocha GM, Wall KM, Chávez-Peralta M, Salinas-Martínez AM, Benavides-Torres RA
Language: English
References: 35
Page: 291-299
PDF size: 182.83 Kb.
ABSTRACT
Background. Nutritional status and nutritional care have
long been ignored among HIV/AIDS patients. Furthermore, in
Mexico there is no information on potential factors favoring
weight increase in such population.
Objective. To assess the
association between the time period since diagnosis,
demographics and BMI in different categories of patients with
HIV/AIDS in Monterrey, Mexico. In addition, to provide
information on overweight/obesity prevalence and nutritional
care referral. Material and methods. This was a crosssectional
study of HIV/AIDS positive patients receiving
outpatient secondary care (n = 231). Nutritional care referral,
time period since diagnosis and demographic data were
obtained by interview. A standardized and registered dietitian
collected anthropometrics measures. Binary multiple logistic
regression was used to evaluate the association between
increasing BMI categories and variables of interest.
Results.
Mean patient age was 40.6 ± 11.2 years, 87% were male,
79.2% were economically active, 65% were single and 60% had
less than a college education. The average time since
diagnosis was 6.5 ± 5.4 years. Overweight and obesity
prevalence were 35.8% and 12.5%, respectively. Only 18% of
patients had ever been referred for nutritional care. The
time period since diagnosis, the sum of skinfold
measurements and the waist-to-hip ratio, were significantly
predictive of the BMI category (normal/underweight vs.
overweight/obese), when controlling for nutritional care
referral and daily carbohydrate intake; age and marital status
were not associated with BMI category.
Conclusions.
Identification of predisposing factors to overweight/obesity
among HIV/AIDS patients constitutes a significant step for
providing nutritional care, of the same importance as the load
or CD4+ count, especially nowadays, with more common
increased survival rates and consequently, longer lives with
the disease.
REFERENCES
World Health Organization. HIV/AIDS. Data and statistics. Global epidemic and health care response . Available in www.who int/hiv/data/en/.
Shikuma CM, Zacklin R, Sattler F, Mildvan D, Nyangweso P, Alston B, Evans S, et al. Changes in weight and lean body mass during highly active antiretroviral therapy. Clin Infect Dis 2004; 39: 1223-30.
de Pee S, Semba RD. Role of nutrition in HIV infection: review of evidence for more effective programming in resourcelimited settings. Food Nutr Bull 2010; 31(4): S313-S344.
Amorosa V, Synnestvedt M, Gross R, Friedman H, Mac Gregor RR, Gudonis D, et al. A tale of 2 epidemics: the intersection between obesity and HIV infection in Philadelphia. J Acquir Immune Defic Syndr 2005; 39(5): 557–61.
Mulligan K, Harris DR, Monte D, Stoszek S, Emmanuel P, Hardin DS, et al. Obesity and dyslipidemia in behaviorally HIV-infected young women: Adolescent Trials Network Study 021. Clin Infect Dis 2010; 50(1): 106-14.
Crum-Cianflone NF, Roediger M, Eberly LE, Vyas K, Landrum ML, Ganesan A, et al. Obesity among HIV-infected persons: impact of weight on CD4 cell count. AIDS 2010; 24(7):1069-72.
Tate T, Willig AL, Willig JH, Raper JL, Moneyham L, Kempf MC, Saag MS, et al. HIV infection and obesity: where did all the wasting go? Antivir Ther 2012; 7(7): 1281-9.
Grunfeld C, Kotler DP, Arnett DK, Falutz JM, Haffner SN, Hruz P, et al. Contribution of metabolic and anthropometric abnormalities to cardiovascular disease risk factors. Circulation 2008; 118: e20-e28.
Samaras K, Wand H, Law M, Emery S, Cooper D, Carr A. Prevalence of metabolic syndrome in HIV-infected patients receiving highly active antiretroviral therapy using International Diabetes Foundation and Adult Treatment Panel III criteria: associations with insulin resistance, disturbed body fat compartmentalization, elevated C-reactive protein, and hypoadiponectinemia. Diabetes Care 2007; 30(1): 113-19.
Grunfeld C, Delaney JAC, Currier JS, Scherzer R, Biggs ML, Shlipak M, et al. Pre-Clinical Atherosclerosis due to HIV: carotid intima medial thickness measurements from the FRAM Study. AIDS 2009; 23(14): 1841-9.
Baker JV, Henry WK, Neaton JD. The consequences of HIV infection and antiretroviral therapy use for cardiovascular disease risk: shifting paradigms. Curr Opin HIV AIDS 2009; 4(3): 176-82.
Madec Y, Szumilin E, Genevier C, Ferradini L, Balkan S, Pujades M, et al. Weight gain at 3 months of antiretroviral therapy is strongly associated with survival: evidence from two developing countries. AIDS 2009; 23(7): 853-61.
World Health Organization. Essential prevention and care interventions for adults and adolescents living with HIV in resource- limited settings. Geneva: WHO; 2008.
Kotler DP. Nutritional alterations associated with HIV infection. J Acquir Immune Defic Syndr 2000; 25(Suppl. 1): S81- S87.
Gillespie S, Haddad LJ, Jackson R. VIH/SIDA, Seguridad alimentaria y seguridad nutricional; repercusiones y medidas.Washinton DC: International Food Policy Research Institute. World Food Programme 2001; 126392.
Palermo B, Bosch RJ, Bennett K, Jacobson JM. Body mass index and CD4+ T-lymphocyte recovery in HIV-infected men with viral suppression on antiretroviral therapy. HIV Clin Trials 2011; 12(4): 222-7.
Mariz C de A, Albuquerque M de F, Ximenes RA, Ramos H, Bandeira F, Oliveira TG, et al. Body mass index in individuals with HIV infection and factors associated with thinness and overweight/obesity. Cad Saúde Pública 2011; 27(10): 1997- 2008.
Leite LHM, Sampaio ABMM. Metabolic abnormalities and overweight in HIV/AIDS persons treated with antiretroviral therapy. Rev Nutr 2008; 21(3): 277-83.
Durnin JVGA, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: Measurements on 481 men and women aged from 16 to 72 years. Br J Nutr 1974; 32: 77-97.
NUTRIS Versión 1.0 ® Software. Sistema de Evaluación Dietética y Antropométrica (versión para Windows). Facultad de Salud Pública y Nutrición. Universidad Autónoma de Nuevo León. México 2005.
Bourges H, Casanueva E, Rosado JL. Recomendaciones de ingestión de nutrimentos para la población mexicana. Bases fisiológicas, vitaminas y nutrimentos inorgánicos: México: Editorial Panamericana; 2005.
Jaime PC, Florindo AA, Latorre Mdo R, Segurado AA. Central obesity and dietary intake in HIV/AIDS patients. Rev Saúde Pública 2006; 40(4): 634-40.
Parikh NI, Pencina MJ, Wang TJ, Lanier KJ, Fox CS. Increasing trends in incidence of overweight and obesity over 5 decades. Am J Med 2007; 120: 242-50.
Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Ávila M, Sepúlveda- Amor J. Encuesta Nacional de Salud y Nutrición 2006. Cuernavaca, México: Instituto Nacional de Salud Pública; 2006.
Gutiérrez JP, Rivera-Dommarco J, Shamah-Levy T, Villapando- Hernández S, Franco A, Cuevas-Nasu L, Romero-Martínez M, et al. Encuesta Nacional de Salud y Nutrición 2012. Resultados Nacionales. Cuernavaca, México: Instituto Nacional de Salud Pública; 2012.
Mexican Social Security Institute (IMSS). Programs Integrated of Health. Technical guide: México; 2002.
Clarke TR, Gibson RC, Barrow G, Abel WD, Barton EM. Depression among Person Attending a HIV/AIDS Outpatient clinic in Kingston, Jamaica. West Indian Med J 2010; 59(4): 369-73.
Dong KR, Hendricks KM. The role of nutrition in fat deposition and fat atrophy in patients with HIV. Nutr Clin Care 2005; 8(1): 31-6.
Shevitz A, Wanke CA, Falutz J, Kotler P. Clinical perspectives on HIV-associated lipodystrophy syndrome: an update. AIDS 2001; 15: 1917-30.
Sierra-Madero J, Villasís-Keever A, Méndez P, Mosqueda-Gómez JL, Torres-Escobar I, Gutiérrez-Escolano F, et al. Prospective, randomized, open label trial of efavirenz vs. lopinavir/ ritonavir in HIV+ treatment-naive subjects with CD4+ < 200 cell/mm3 in Mexico. J Acquir Immune Defic Syndr 2010; 53(5): 582-8.
Tadewos A, Addis Z, Ambachew H, Banerjee S. Prevalence of dyslipidemia among HIV-infected patients using first-line highly active antiretroviral therapy in Southern Ethiopia: a crosssectional comparative group study. AIDS Research and Therapy 2012; 9: 31.
Awah FM, Agughasi O. Effect highly active anti-retroviral therapy (HAART) on lipid profile in a human immunodeficiency virus (HIV) infected Nigerian population. African Journal of Biochemistry Research 2011; 5(9).
Portilla J. Factores de riesgo cardiovascular dependientes del paciente en población con infección por VIH. Enfermedades Infecciosas y Microbiología Clínica 2009; 27: 10-16.
Cahn P, Leite O, Rosales A, Cabello R, Álvarez CA, Cárcamo C, et al. Metabolic profile and cardiovascular risk factors among Latin American HIV-infected patients receiving HAART. Braz J infect Dis 2010; 14(2): 158-66.
Janiszewski P, Ross R, Despres J-P, Lemieux I, Orlando G, Carli F, et al. Hypertriglyceridemia and waist circumference predict cardiovascular risk among HIV patients: a cross-sectional study. Plos One 2011; 6(9).