Gupta Aakriti, Pramod K, Aggarwal Anuja, Bhargava Madhavi, Phadiyal Ashima, Gulfam Fazlur R, Mitra Rochana
Department of Programmes and Policy, India HIV/AIDS Alliance, New Delhi, India.
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Indian J Community Med. 2025 May-Jun;50(3):407-412. doi: 10.4103/ijcm.ijcm_580_23. Epub 2025 Feb 1.
A high prevalence of undernutrition (40%) exists among adults living with HIV (ALHIV) in India due to their increased metabolic demands. Diminished nutritional status in turn has been associated with increased risk of morbidity and mortality among ALHIV. Nutritional assessment and its management are an integral part of HIV care; however, no strategy exists for screening of undernutrition among ALHIV.
The nutrition care model has been developed for undertaking nutritional assessment by classifying the severity of undernutrition based on body mass index (BMI) and identification of early signs of undernutrition including anemia and hypoalbuminemia among ALHIV.
The model suggests energy and protein intake based on the BMI and indicates desirable body weight corresponding to a BMI of 21 kg/m. Based on these requirements, the portion size of each major food group is provided for individualized dietary counseling by frontline workers. ALHIV found with signs and symptoms of anemia, low hemoglobin, and serum albumin are referred to the nearest health facility. Large-scale operational research and field validation studies are planned to better understand the effectiveness of the model in improving the nutritional and clinical outcomes and the strengths and limitations as an operational tool in programmatic settings.
由于代谢需求增加,印度成年艾滋病病毒感染者(ALHIV)中存在较高的营养不良患病率(40%)。营养状况不佳反过来又与ALHIV发病和死亡风险增加有关。营养评估及其管理是艾滋病护理的一个组成部分;然而,目前尚无针对ALHIV中营养不良筛查的策略。
已开发出营养护理模型,用于通过根据体重指数(BMI)对营养不良的严重程度进行分类以及识别ALHIV中包括贫血和低白蛋白血症在内的营养不良早期迹象来进行营养评估。
该模型根据BMI建议能量和蛋白质摄入量,并指出对应于BMI为21 kg/m²的理想体重。根据这些要求,为一线工作人员提供每个主要食物组的份量,以进行个性化饮食咨询。发现有贫血、低血红蛋白和血清白蛋白体征和症状的ALHIV被转诊至最近的医疗机构。计划开展大规模的运筹学研究和现场验证研究,以更好地了解该模型在改善营养和临床结果方面的有效性以及作为项目环境中的操作工具的优势和局限性。