Stack J A, Bell S J, Burke P A, Forse R A
Surgical Metabolism Laboratory, Deaconess Hospital, Cancer Research Institute, Boston, MA,02215, USA.
J Am Diet Assoc. 1996 Apr;96(4):337-41. doi: 10.1016/S0002-8223(96)00095-8.
to evaluate the use of high-energy, high-protein, oral, liquid, nutrition supplementation and nutrition counseling on the weight status of patients infected with the human immunodeficiency virus (HIV) with and without secondary infections.
Prospective, descriptive, intervention trial. Follow-up clinic visits were scheduled every 1 to 3 weeks for at least 6 weeks to monitor weight, gastrointestinal symptoms, number of supplements consumed, and incidence of secondary infections.
SUBJECTS/SETTING: Community-based, HIV-infected patients, with and without an acquired immunodeficiency syndrome (AIDS) defining illness, who were receiving outpatient medical care at Deaconess Hospital. Twenty-two patients enrolled; however, 4 dropped out and 1 died, so 17 were eligible for evaluation.
Dietary counseling consisted of recommendations to consume a high-protein diet (1.5 g/kg ideal body weight); select foods that minimize gastrointestinal complications; and take at least one high-energy, high-protein, oral, liquid, nutrition supplement daily.
Energy intake from the supplements and weight change over time in relation to whether a secondary infection occurred.
Means, standard deviations, and frequency.
At the time of entry to the study, the patients with preexisting weight loss (16 of 17) were 14+/-8% below their usual body weight. On average, patients consumed 11+/-4 supplements per week for 6+/-3 weeks. The majority (12 of 17) were able to gain or maintain weight. Overall weight change was 1.1+/-2.2 kg. Only 5 of 17 patients lost weight, 4 of whom developed a secondary infection during the study (ie, after enrollment in the study). All of those who developed a secondary infection were classified as having AIDS and had lower mean CD4 counts at baseline than those who did not develop a secondary infection. Although those who developed a secondary infection had a higher incidence of weight loss, their consumption of oral supplements per week was greater than that of those without a secondary infection.
APPLICATIONS/CONCLUSIONS: In patients with HIV infection and in the early stages of AIDS without a secondary infection, weight gain and/or maintenance was achievable with a high-energy, high-protein, oral, liquid, nutrition supplement in conjunction with nutrition counseling. The majority of the patients who developed a secondary infection, however, lost weight despite the use of supplements and counseling. Use of a high-energy, high-protein, oral, liquid, nutrition supplement, with intact nutrients, should be the first-line nutrition treatment for malnourished, HIV-infected patients without secondary infections.
评估使用高能、高蛋白、口服液体营养补充剂及营养咨询对有无继发感染的人类免疫缺陷病毒（HIV）感染者体重状况的影响。
前瞻性、描述性干预试验。计划每1至3周进行一次随访门诊，为期至少6周，以监测体重、胃肠道症状、补充剂摄入量及继发感染发生率。
研究对象/研究地点：以社区为基础的HIV感染者，无论有无获得性免疫缺陷综合征（AIDS）相关疾病，均在女执事医院接受门诊医疗护理。22名患者入组；然而，4人退出，1人死亡，因此17人符合评估条件。
饮食咨询包括建议摄入高蛋白饮食（1.5 g/kg理想体重）；选择可将胃肠道并发症降至最低的食物；以及每天至少服用一种高能、高蛋白、口服液体营养补充剂。
补充剂的能量摄入以及继发感染发生与否随时间的体重变化。
均值、标准差及频率。
在研究开始时，已有体重减轻的患者（17例中的16例）比其正常体重低14±8%。患者平均在6±3周内每周服用11±4份补充剂。大多数患者（17例中的12例）能够增加或维持体重。总体体重变化为1.1±2.2 kg。17例患者中只有5例体重减轻，其中4例在研究期间（即入组研究后）发生了继发感染。所有发生继发感染的患者均被归类为患有AIDS，且其基线时的平均CD4细胞计数低于未发生继发感染的患者。尽管发生继发感染的患者体重减轻发生率较高，但他们每周口服补充剂的摄入量高于未发生继发感染的患者。
应用/结论：对于HIV感染且处于AIDS早期且无继发感染的患者，联合营养咨询使用高能、高蛋白、口服液体营养补充剂可实现体重增加和/或维持。然而，大多数发生继发感染的患者尽管使用了补充剂和咨询服务，体重仍减轻。对于未发生继发感染的营养不良HIV感染者，使用营养成分完整的高能、高蛋白、口服液体营养补充剂应作为一线营养治疗方法。
