宏量营养素补充对营养状况及HIV/AIDS进展的有效性：一项系统评价与荟萃分析
Effectiveness of macronutrient supplementation on nutritional status and HIV/AIDS progression: A systematic review and meta-analysis.
作者信息
Hong Hyejeong, Budhathoki Chakra, Farley Jason E
机构信息
Johns Hopkins University School of Nursing, Department of Community-Public Health, 525 North Wolfe Street, Baltimore, MD, 21205, USA; Johns Hopkins University School of Nursing, The REACH Initiative, 1909 McElderry Street, SON House, Baltimore, MD, 21205, USA.
Johns Hopkins University School of Nursing, Department of Acute and Chronic Care, 525 North Wolfe Street, Baltimore, MD, 21205, USA.
出版信息
Clin Nutr ESPEN. 2018 Oct;27:66-74. doi: 10.1016/j.clnesp.2018.06.007. Epub 2018 Jul 6.
BACKGROUND & AIMS: Malnutrition is common in Sub-Saharan Africa, weakening the immune function of persons living with HIV infection (PLWH). Being malnourished at the initiation of antiretroviral therapy (ART) leads to higher risk of early mortality and reduced quality of life. Thus, introduction of protein-energy-fortified macronutrient supplements at ART initiation may improve HIV treatment outcomes. This review aimed to evaluate the effectiveness of macronutrient interventions.
METHODS
This systematic review and meta-analysis included 15 studies conducted from 2000 to 2015 among Sub-Saharan African adults.
RESULTS
Six randomized controlled trials and 4 retrospective cohort studies provided data eligible for a meta-analysis. Supplementation significantly increased the overall standardized mean difference (SMD) between baseline and follow-up data in weight (SMD = 0.382, p < .001), BMI (SMD = 0.799, p < .001); fat-free mass (SMD = 0.154, p = .009); and CD4 count (SMD = 0.428, p < .001).
CONCLUSION
Protein-energy-fortified macronutrient supplementation at ART initiation may positively influence nutritional status and immunologic response in PLWH in Sub-Saharan Africa.
背景与目的
营养不良在撒哈拉以南非洲地区很常见，会削弱艾滋病毒感染者（PLWH）的免疫功能。在开始抗逆转录病毒治疗（ART）时营养不良会导致更高的早期死亡风险和生活质量下降。因此，在开始ART时引入蛋白质 - 能量强化的宏量营养素补充剂可能会改善艾滋病毒治疗效果。本综述旨在评估宏量营养素干预措施的有效性。
方法
本系统综述和荟萃分析纳入了2000年至2015年在撒哈拉以南非洲成年人中进行的15项研究。
结果
六项随机对照试验和四项回顾性队列研究提供了符合荟萃分析条件的数据。补充剂显著增加了体重（标准化均数差[SMD]=0.382，p<.001）、体重指数（BMI）（SMD = 0.799，p<.001）、去脂体重（SMD = 0.154，p =.009）和CD4细胞计数（SMD = 0.428，p<.001）的基线和随访数据之间的总体标准化均数差。
结论
在开始ART时补充蛋白质 - 能量强化的宏量营养素可能会对撒哈拉以南非洲地区PLWH的营养状况和免疫反应产生积极影响。
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