Agordoh Percival Delali, Lokpo Sylvester Yao, Owiredu William K B A, Orish Verner N, Tettey Clement Okraku, Sah John Agyemang, Kuatsienu Lydia Enyonam, Ameke Louis Selassie, Osei-Yeboah James
Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana.
Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana.
Heliyon. 2022 Aug 28;8(8):e10436. doi: 10.1016/j.heliyon.2022.e10436. eCollection 2022 Aug.
Metabolic and nutritional abnormalities among people living with human immunodeficiency virus (PLHIV) have been reported due to either their HIV infection, primary malnutrition caused by insufficient intake or consequences of the ART regimen provided. This study investigated the prevalence and patterns of nutritional abnormalities including morphological changes among HIV patients under combination Antiretroviral Therapy (cART) in the Bia-West District of the Western North Region.
We employed a hospital-based retrospective longitudinal design. Records of 180 patients with HIV infection before and after antiretroviral therapy (ART) initiation were extracted at the Essam Government Hospital. Eligibility criteria included being on treatment without change in regimen for at least one year and without defaulting in scheduled visits. Data extracted included patients' demography, nutritional parameters and medication history. We assessed patients' nutritional characteristics with the subjective global assessment (SGA) tool which includes five components of medical history (weight change, dietary intake, gastrointestinal symptoms, functional capacity & metabolic stress) and two components of physical examination (signs of fat loss and muscle wasting, alterations in fluid balance).
Malnutrition, lipodystrophy and body wasting among HIV patients were 48.3% (36.5-62.4), 43.9% (32.6-57.7) and 33.3% (23.6-46.0) respectively. Incremental percentage trends of malnutrition (stage I- 7.4%, stage II -22.4%, stage III-24.7%) and lipodystrophy (Stage I - 22.2%, Stage II - 48.7%, Stage III - 51.9%) were significantly associated with worsening disease status. Patients on AZT+3TC + NVP combined regimen presented with the highest malnutrition [52.9% (28.5-76.1)], lipodystrophy [64.7% (38.6-84.7)] and loss of muscle mass [47.1% (23.9-71.5)]. Long-term ART use was significantly associated with high malnutrition rate and increasing muscle mass loss .
High malnutrition, lipodystrophy and muscle wasting exist in PLHIV on cART in the Bia-West District. These adverse nutritional effects may be modulated by disease severity, ARV medication and duration.
据报道，感染人类免疫缺陷病毒（PLHIV）的人群存在代谢和营养异常，原因可能是他们感染了艾滋病毒、因摄入不足导致的原发性营养不良或所提供的抗逆转录病毒治疗方案的后果。本研究调查了西北地区比阿西区接受联合抗逆转录病毒治疗（cART）的艾滋病毒患者中营养异常的患病率和模式，包括形态学变化。
我们采用了基于医院的回顾性纵向设计。在埃萨姆政府医院提取了180例艾滋病毒感染患者在开始抗逆转录病毒治疗（ART）前后的记录。纳入标准包括接受治疗且治疗方案至少一年未改变且未错过预定就诊。提取的数据包括患者的人口统计学、营养参数和用药史。我们使用主观全面评定（SGA）工具评估患者的营养特征，该工具包括病史的五个组成部分（体重变化、饮食摄入、胃肠道症状、功能能力和代谢应激）和体格检查的两个组成部分（脂肪减少和肌肉萎缩的体征、液体平衡改变）。
艾滋病毒患者的营养不良、脂肪代谢障碍和身体消瘦发生率分别为48.3%（36.5 - 62.4）、43.9%（32.6 - 57.7）和33.3%（23.6 - 46.0）。营养不良（I期 - 7.4%，II期 - 22.4%，III期 - 24.7%）和脂肪代谢障碍（I期 - 22.2%，II期 - 48.7%，III期 - 51.9%）的递增百分比趋势与疾病状况恶化显著相关。接受齐多夫定 + 拉米夫定 + 奈韦拉平联合方案治疗的患者营养不良发生率最高[52.9%（28.5 - 76.1）]、脂肪代谢障碍发生率最高[64.7%（38.6 - 84.7）]和肌肉量减少发生率最高[47.1%（23.9 - 71.5）]。长期使用抗逆转录病毒治疗与高营养不良率和肌肉量增加显著相关。
比阿西区接受cART治疗的艾滋病毒感染者存在高营养不良、脂肪代谢障碍和肌肉消瘦。这些不良营养影响可能受疾病严重程度、抗逆转录病毒药物和治疗持续时间的调节。
