Pienaar Michélle, van Rooyen Francois C, Walsh Corinna M
Department of Nutrition and Dietetics, University of the Free State, South Africa.
Department of Biostatistics, University of the Free State, South Africa.
South Afr J HIV Med. 2017 Aug 28;18(1):465. doi: 10.4102/sajhivmed.v18i1.465. eCollection 2017.
HIV infection impacts heavily on the infected individual's overall health status.
To determine significant health, lifestyle (smoking and alcohol use) and independent clinical manifestations associated with HIV status in rural and urban communities.
Adults aged between 25 and 64 years completed a questionnaire in a structured interview with each participant. Blood specimens were analysed in an accredited laboratory using standard techniques and controls. Anthropometric measurements were determined using standardised methods.
Of the 567 rural participants, 97 (17.1%) were HIV-infected, and 172 (40.6%) of the 424 urban participants. More than half of HIV-infected rural participants used alcohol and more than 40% smoked. Median body mass index (BMI) of HIV-infected participants was lower than that of uninfected participants. Significantly more HIV-infected participants reported experiencing cough (rural), skin rash (urban), diarrhoea (rural and urban), vomiting (rural), loss of appetite (urban) and involuntary weight loss (rural). Significantly more HIV-uninfected participants reported diabetes mellitus (urban) and high blood pressure (rural and urban). In rural areas, HIV infection was positively associated with losing weight involuntarily (odds ratio 1.86), ever being diagnosed with tuberculosis (TB) (odds ratio 2.50) and being on TB treatment (odds ratio 3.29). In the urban sample, HIV infection was positively associated with having diarrhoea (odds ratio 2.04) and ever being diagnosed with TB (odds ratio 2.49).
Involuntary weight loss and diarrhoea were most likely to predict the presence of HIV. In addition, present or past diagnosis of TB increased the odds of being HIV-infected. Information related to diarrhoea, weight loss and TB is easy to obtain from patients and should prompt healthcare workers to screen for HIV.
HIV感染对感染者的整体健康状况有严重影响。
确定农村和城市社区中与HIV感染状况相关的重要健康、生活方式（吸烟和饮酒）及独立临床表现。
年龄在25至64岁之间的成年人在结构化访谈中完成问卷，每位参与者均接受访谈。血液样本在认可的实验室采用标准技术和对照进行分析。人体测量采用标准化方法。
在567名农村参与者中，97人（17.1%）感染了HIV；在424名城市参与者中，172人（40.6%）感染了HIV。超过一半的农村HIV感染者饮酒，超过40%吸烟。HIV感染者的体重指数（BMI）中位数低于未感染者。报告出现咳嗽（农村）、皮疹（城市）、腹泻（农村和城市）、呕吐（农村）、食欲不振（城市）和体重非自愿减轻（农村）的HIV感染者明显更多。报告患有糖尿病（城市）和高血压（农村和城市）的未感染HIV者明显更多。在农村地区，HIV感染与体重非自愿减轻（比值比1.86）、曾被诊断患有结核病（TB）（比值比2.50）以及正在接受结核病治疗（比值比3.29）呈正相关。在城市样本中，HIV感染与腹泻（比值比2.04）和曾被诊断患有结核病（比值比2.49）呈正相关。
体重非自愿减轻和腹泻最有可能预示HIV的存在。此外，目前或过去诊断为结核病会增加感染HIV的几率。与腹泻、体重减轻和结核病相关的信息易于从患者处获取，应促使医护人员对HIV进行筛查。
