[感染艾滋病毒/艾滋病者的营养状况；其与T CD4+细胞计数的关系]

[Nutritional status of the persons living with HIV/AIDS; its relationship with T CD4+ cells counts].

作者信息

Linares Guerra Elisa Maritza, Santana Porbén Sergio, Carrillo Fornés Olimpia, León Sánchez Maria Amparo, Sanabria Negrín José Guillermo, Acosta Núñez Nadia, Pla Cruz Alina, Coniell Linares Emilia

机构信息

Universidad de Ciencias Médicas de Pinar del Río. Pinar del Río. Cuba..

出版信息

Nutr Hosp. 2013 Nov 1;28(6):2197-207.

PMID:24506402

Abstract

RATIONALE

Malnutrition might be present in people living with HIV/aids (PHIV/aids), and be associated with derangement of the immune system.

OBJECTIVE

To assess the association between the nutricional status of the PHIV/aids and the counts of T CD4+ cells.

STUDY DESIGN

Observational, analytical and cross-sectional.

METHODS

The nutricional status of 217 PHIV/aids in the Pinar del Río province, Cuba (Men: 72.4%; Age at the moment of HIV/aids diagnosis: < 30 years: 62.2%; CD4+ Counts < 350 cells x mm(-3): 32.3%; Anti-retroviral therapy: 33.2%) was indistinctively established by means of the Body Mass Index (BMI), the Global Subjective Assessment (SGA) and the Chang's algorithm. The association between the nutritional status and the CD4+ counts was estimated from the corresponding odds-ratios (OR), indistinctively calculated from the cross-products ratios of a 2 x 2 contingency table; or the coefficients of the logistic regression model.

RESULTS

Malnutrition frequency was dependent from the nutritional assessment method: BMI: 3.7%; Chang's algorithm: 8.8%; SGA: 10.6%; respectively. Nutritional status was weakly associated with CD4+ counts: BMI: ORContingencyTable = 3.69 (p > 0.05); Chang's algorithm: ORContingencyTable = 2.55 (p = 0.047); and SGA: ORContingencyTable = 1.72 (p > 0.05); respectively. When the study serie was adjusted according anti-retroviral therapy (ARVT), association between CD4+ and nutritional status was as follows: BMI: ORLogisticRegression = 0.367 (p = 0.083); Chang's Algorithm: ORLogisticRegression = 2.604 (p = 0.050); and SGA: ORLogisticRegression = 1.714 (p = 0.232); respectively.

CONCLUSIONS

Inception of ARVT modifies the association that might exist between the immune system and nutritional status. Reduction of CD4+ counts in a PHIV/aids was weakly associated with derangement of nutritional indicators. It is likely that body weight excess might be modifying this association: 29.0% of the studied PHIV/aids had BMI values >= 25.0 Kg x m(-2).

摘要

理论依据

感染艾滋病毒/艾滋病的人（PHIV/aids）可能存在营养不良，并与免疫系统紊乱有关。

目的

评估PHIV/aids的营养状况与T CD4+细胞计数之间的关联。

研究设计

观察性、分析性和横断面研究。

方法

通过体重指数（BMI）、全球主观评估（SGA）和常氏算法，对古巴比那尔德里奥省217例PHIV/aids患者（男性：72.4%；艾滋病毒/艾滋病诊断时年龄：<30岁：62.2%；CD4+计数<350个细胞×mm(-3)：32.3%；抗逆转录病毒治疗：33.2%）的营养状况进行了无差别评估。营养状况与CD4+计数之间的关联通过相应的比值比（OR）进行估计，OR分别根据2×2列联表的交叉乘积比或逻辑回归模型的系数无差别计算得出。

结果

营养不良频率取决于营养评估方法：BMI为3.7%；常氏算法为8.8%；SGA为10.6%。营养状况与CD4+计数之间的关联较弱：BMI：列联表OR = 3.69（p>0.05）；常氏算法：列联表OR = 2.55（p = 0.047）；SGA：列联表OR = 1.72（p>0.05）。当根据抗逆转录病毒治疗（ARVT）对研究系列进行调整后，CD4+与营养状况之间的关联如下：BMI：逻辑回归OR = 0.367（p = 0.083）；常氏算法：逻辑回归OR = 2.604（p = 0.050）；SGA：逻辑回归OR = 1.7l4（p = 0.232）。