Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
Department of Medicine, McGill University, Montreal, QC, Canada.
HIV Med. 2018 Feb;19(2):123-131. doi: 10.1111/hiv.12561. Epub 2017 Nov 2.
The aim of this study was to determine the impact of food insecurity (FI) on HIV viral load and CD4 count among people coinfected with HIV and hepatitis C virus (HCV).
This study was conducted using data from the Food Security & HIV-HCV Sub-Study of the Canadian Co-Infection Cohort study. FI was measured using the adult scale of Health Canada's Household Food Security Survey Module and was classified into three categories: food security, moderate food insecurity and severe food insecurity. The association between FI, HIV viral load, and CD4 count was assessed using a stabilized inverse probability weighted marginal structural model.
A total of 725 HIV/HCV-coinfected people with 1973 person-visits over 3 years of follow-up contributed to this study. At baseline, 23% of participants experienced moderate food insecurity and 34% experienced severe food insecurity. The proportion of people with undetectable HIV viral load was 75% and the median CD4 count was 460 [interquartile range (IQR): 300-665] cells/μL. People experiencing severe food insecurity had 1.47 times [95% confidence interval (CI): 1.14, 1.88] the risk of having detectable HIV viral load and a 0.91-fold (95% CI: 0.84, 0.98) increase in CD4 count compared with people who were food secure.
These findings provide evidence of the negative impact of food insecurity on HIV viral load and CD4 count among HIV/HCV-coinfected people.
本研究旨在确定食物不安全（FI）对 HIV 和丙型肝炎病毒（HCV）合并感染人群中 HIV 病毒载量和 CD4 计数的影响。
本研究使用加拿大合并感染队列研究的食物安全与 HIV-HCV 子研究的数据进行。使用加拿大卫生部家庭食物安全调查模块的成人量表来衡量 FI，并将其分为三类：食物安全、中度食物不安全和严重食物不安全。使用稳定逆概率加权边际结构模型评估 FI、HIV 病毒载量和 CD4 计数之间的关联。
本研究共纳入了 725 名 HIV/HCV 合并感染的患者，他们在 3 年的随访中共有 1973 人次就诊。在基线时，23%的参与者经历了中度食物不安全，34%经历了严重食物不安全。有 75%的人 HIV 病毒载量无法检测到，中位数 CD4 计数为 460[四分位间距（IQR）：300-665]细胞/μL。经历严重食物不安全的人 HIV 病毒载量可检测的风险是食物安全人群的 1.47 倍（95%置信区间（CI）：1.14，1.88），CD4 计数增加了 0.91 倍（95%CI：0.84，0.98）。
这些发现为食物不安全对 HIV/HCV 合并感染人群中 HIV 病毒载量和 CD4 计数的负面影响提供了证据。
