McKinley M J, Goodman-Block J, Lesser M L, Salbe A D
Center for Special Studies, New York Hospital, NY.
J Am Diet Assoc. 1994 Sep;94(9):1014-7. doi: 10.1016/0002-8223(94)92195-4.
Malnutrition is an important consequence of infection with the human immunodeficiency virus (HIV); involuntary weight loss greater than 10% is one criterion that the Centers for Disease Control and Prevention uses for the diagnosis of acquired immunodeficiency syndrome (AIDS). This study was designed to determine whether nutrition intervention in a group of adult, HIV-positive outpatients affected weight maintenance.
We undertook a retrospective review of 175 patient charts from the AIDS Reproductive Health Clinic and the Center for Special Studies at The New York Hospital. Forty-nine charts were excluded because the patient expressed a desire to reduce weight, discontinued medical care, or died. Seven charts were eliminated because of missing data. In the remaining patients (n = 119), weights were recorded for the initial clinic contact and for a follow-up visit at least 6 months later. Nutrition intervention completed by a registered dietitian was indicated on 42 patient charts (intervention group); intervention included dietary assessment, intake analysis, appropriate counselling, follow-up, and provision of supplements as needed. The remaining 77 charts did not indicate nutrition intervention; this group was called the nonintervention group. Differences between the intervention and nonintervention groups were analyzed using the two-tailed Fisher exact test and the Mann-Whitney nonparametric test.
Forty-two subjects (35% of the total) recieved nutrition intervention, including all of those with gastrointestinal problems (n = 10) and wasting (n = 11). Individuals in the intervention group gained a significant (P < .02) 1.2 +/- 11.4 lb (mean +/- standard deviation; median = +3 lb) compared with those in the nonintervention group who lost a mean of 3.5 +/- 12.8 lb (median = -4 lb). Twenty-six subjects (63%) in the intervention group maintained or gained weight compared with 32 subjects (42%), in the nonintervention group.
The results of this study suggest that nutrition intervention in HIV-infected persons can improve nutritional status and may lead to an enhanced ability to fight infection.
营养不良是人类免疫缺陷病毒(HIV)感染的一个重要后果;体重非自愿性减轻超过10%是美国疾病控制与预防中心用于诊断获得性免疫缺陷综合征(AIDS)的一项标准。本研究旨在确定对一组成年HIV阳性门诊患者进行营养干预是否会影响体重维持。
我们对纽约医院艾滋病生殖健康诊所和特殊研究中心的175份患者病历进行了回顾性分析。49份病历被排除,原因是患者表示希望减重、停止医疗护理或死亡。7份病历因数据缺失而被剔除。在其余患者(n = 119)中,记录了初次门诊就诊时以及至少6个月后的随访就诊时的体重。42份患者病历(干预组)显示由注册营养师完成了营养干预;干预包括饮食评估、摄入量分析、适当的咨询、随访以及根据需要提供补充剂。其余77份病历未显示营养干预;该组被称为非干预组。使用双侧Fisher精确检验和Mann-Whitney非参数检验分析干预组和非干预组之间的差异。
42名受试者(占总数的35%)接受了营养干预,包括所有有胃肠道问题的患者(n = 10)和消瘦患者(n = 11)。与非干预组相比,干预组个体体重显著增加(P < 0.02),平均增加1.2 ± 11.4磅(均值 ± 标准差;中位数 = +3磅),而非干预组平均体重减轻3.5 ± 12.8磅(中位数 = -4磅)。干预组有26名受试者(63%)体重维持或增加,而非干预组有32名受试者(42%)体重维持或增加。
本研究结果表明,对HIV感染者进行营养干预可改善营养状况,并可能增强抗感染能力。