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AIDS and Behavior
Published in: AIDS and Behavior 6/2013

01-07-2013 | Original Paper

Impact of Protein Supplementation and Care and Support on Body Composition and CD4 Count Among HIV-Infected Women Living in Rural India: Results from a Randomized Pilot Clinical Trial

Authors: Adeline Nyamathi, Sanjeev Sinha, Kalyan K. Ganguly, Padma Ramakrishna, P. Suresh, Catherine L. Carpenter

Published in: AIDS and Behavior | Issue 6/2013

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Abstract

Body composition in HIV-infected individuals is subject to many influences. We conducted a pilot 6-month randomized trial of 68 women living with AIDS (WLA) from rural India. High protein intervention combined with education and supportive care delivered by HIV-trained village women (activated social health activist [Asha] life [AL]) was compared to standard protein with usual care delivered by village community assistants (usual care [UC]). Measurements included CD4 counts, ART adherence, socio-demographics, disease characteristics (questionnaires); and anthropometry (bioimpedance analyzer). Repeated measures analysis of variance modeled associations. AL significantly gained in BMI, muscle mass, fat mass, ART adherence, and CD4 counts compared to UC, with higher weight and muscle mass gains among ART adherent (≥66 %) participants who had healthier immunity (CD4 ≥450). BMI of WLA improved through high protein supplementation combined with education and supportive care. Future research is needed to determine which intervention aspect was most responsible.
Literature
1.
English RM, Badcock JC, Giay T, Ngu T, Waters AM, Bennett SA. Effect of nutrition improvement project on morbidity from infectious diseases in preschool children in Vietnam: comparison with control commune. BMJ. 1997;315(7116):1122–5.PubMedCrossRef
2.
Mahlungulu S, Grobler LA, Visser ME, Volmink J. Nutritional interventions for reducing morbidity and mortality in people with HIV. Cochrane Database Syst Rev. 2007;(3):CD004536.
3.
Mangili A, Murman DH, Zampini AM, Wanke CA. Nutrition and HIV infection: review of weight loss and wasting in the era of highly active antiretroviral therapy from the nutrition for healthy living cohort. Clin Infect Dis. 2006;42(6):836–42.PubMedCrossRef
4.
Tang AM, Forrester J, Spiegelman D, Knox TA, Tchetgen E, Gorbach SL. Weight loss and survival in HIV-positive patients in the era of highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2002;31(2):230–6.PubMedCrossRef
5.
WHO. Physical status: the use and interpretation of anthropometry. World Health Organization. 1995.
6.
Clark RH, Feleke G, Din M, et al. Nutritional treatment for acquired immunodeficiency virus-associated wasting using beta-hydroxy beta-methylbutyrate, glutamine, and arginine: a randomized, double-blind, placebo-controlled study. JPEN (J Parenter Enter Nutr). 2000;24(3):133–9.CrossRef
7.
de Luis D, Aller R, Bachiller P, et al. Isolated dietary counselling program versus supplement and dietary counselling in patients with human immunodeficiency virus infection. Med Clin (Barc). 2003;120(15):565–7.CrossRef
8.
Tsai AC, Hung KJ, Weiser SD. Is food insecurity associated with HIV risk? Cross-sectional evidence from sexually active women in Brazil. PLoS Med. 2012;9(4):e1001203.PubMedCrossRef
9.
Weiser SD, Leiter K, Bangsberg DR, et al. Food insufficiency is associated with high-risk sexual behavior among women in Botswana and Swaziland. PLoS Med. 2007;4(10):e260.CrossRef
10.
11.
12.
13.
14.
Rao M, Rao KD, Kumar AK, Chatterjee M, Sundararaman T. Human resources for health in India. Lancet. 2011;377:587–98.PubMedCrossRef
15.
Wadler BM, Judge CM, Prout M, Allen JD, Geller AC. Improving breast cancer control via the use of community health workers in South Africa: a critical review. J Oncol. 2011;150423:1–8.CrossRef
16.
Andersen MR, Yasui Y, Meischke H, Kuniyuki A, Etzioni R, Urban N. The effectiveness of mammography promotion by volunteers in rural communities. Am J Prev Med. 2000;18(3):199–207.PubMedCrossRef
17.
Norris SL, Chowdhury FM, Van Le K, et al. Effectiveness of community health workers in the care of persons with diabetes. Diabet Med. 2006;23(5):544–56.PubMedCrossRef
18.
Brownstein JN, Bone LR, Dennison CR, Hill MN, Kim MT, Levine DM. Community health workers as interventionists in the prevention and control of heart disease and stroke. Am J Prev Med. 2005;29(5 Suppl 1):128–33.PubMedCrossRef
19.
Andrews JO, Felton G, Wewers ME, Heath J. Use of community health workers in research with ethnic minority women. J Nurs Scholarsh. 2004;36(4):358–65.PubMedCrossRef
20.
Lewin SA, Dick J, Pond P, et al. Lay health workers in primary and community health care. Cochrane Database Syst Rev. 2005;(1):CD004015.
21.
Rhodes SD, Foley KL, Zometa CS, Bloom FR. Lay health advisor interventions among Hispanics/Latinos: a qualitative systematic review. Am J Prev Med. 2007;33(5):418–27.PubMedCrossRef
22.
Gogia S, Sachdev HS. Home visits by community health workers to prevent neonatal deaths in developing countries: a systematic review. Bull World Health Organ. 2010;88(9):658–66.PubMedCrossRef
23.
Singh MK, Singh J, Ahmad N, Kumari R, Khanna A. Factors influencing utilization of ASHA services under NRHM in relation to maternal health in rural Lucknow. Indian J Commun Med. 2010;35(3):414–9.CrossRef
24.
Srivastava DK, Prakash S, Adhish V, Nair KS, Gupta S, Nandan D. A study of interface of ASHA with the community and the service providers in Eastern Uttar Pradesh. Indian J Public Health. 2009;53(3):133–6.PubMed
25.
Nyamathi A, Salem BE, Meyer V, Ganguly KK, Sinha S, Ramakrishnan P. Impact of an ASHA intervention on depressive symptoms among rural women living with AIDS in India: comparison of the ASHA Life and Usual Care program. AIDS Educ Prev. 2012;24(3):280–93.PubMedCrossRef
26.
27.
Nyamathi A, Heravian A, Zolt-Gilburne J, et al. Correlates of depression among rural women living with AIDS in Southern India. Issues Ment Health Nurs. 2011;32(6):385–91.PubMedCrossRef
28.
Rotheram-Borus MJ. Expanding the range of interventions to reduce HIV among adolescents. AIDS. 2000;14(Suppl 1):S33–40.PubMedCrossRef
29.
Rotheram-Borus MJ, Stein JA, Lin YY. Impact of parent death and an intervention on the adjustment of adolescents whose parents have HIV/AIDS. J Consult Clin Psychol. 2001;69(5):763–73.PubMedCrossRef
30.
Whitbeck LB, Hoyt DR, Bao WN. Depressive symptoms and co-occurring depressive symptoms, substance abuse, and conduct problems among runaway and homeless adolescents. Child Dev. 2000;71(3):721–32.PubMedCrossRef
31.
Ekstrand ML, Chandy S, Gandhi M, Stewart W, Singh G. “Sometimes just run out”: delays in prescription refills as a risk for the development of HIV drug resistance in India. Toronto: XVI International Conference on AIDS; 2006. [Abstract TUPE0158].
32.
Radloff L. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRef
33.
Vijayaraghavan K. Control of micronutrient deficiencies in India: obstacles and strategies. Nutr Rev. 2002;60(5 Pt 2):S73–6.PubMedCrossRef
34.
McDermott AY, Terrin N, Wanke C, Skinner S, Tchetgen E, Shevitz AH. CD4+ cell count, viral load, and highly active antiretroviral therapy use are independent predictors of body composition alterations in HIV-infected adults: a longitudinal study. Clin Infect Dis. 2005;41(11):1662–70.PubMedCrossRef
35.
Oguntibeju OO, van den Heever WM, van Schalkwyk FE. The interrelationship between nutrition and the immune system in HIV infection: a review. Pak J Biol Sci. 2007;10(24):4327–38.PubMedCrossRef
36.
Chang E, Sekhar R, Patel S, Balasubramanyam A. Dysregulated energy expenditure in HIV-infected patients: a mechanistic review. Clin Infect Dis. 2007;44:1509–17.PubMedCrossRef
37.
AIDS Epidemic update. International consultation on the criminalization of HIV transmission. Geneva: Joint United Nations Programmes on HIV/AIDS and World Health Organization; 2009.
38.
Koethe JR, Chi BH, Megazzini KM, Heimburger DC, Stringer JS. Macronutrient supplementation for malnourished HIV-infected adults: a review of the evidence in resource-adequate and resource-constrained settings. Clin Infect Dis. 2009;49(5):787–98.PubMedCrossRef
39.
Liu E, Spiegelman D, Semu H, et al. Nutritional status and mortality among HIV-infected patients receiving antiretroviral therapy in Tanzania. J Infect Dis. 2011;204(2):282–90.PubMedCrossRef
40.
Paton NI, Sangeetha S, Earnest A, Bellamy R. The impact of malnutrition on survival and the CD4 count response in HIV-infected patients starting antiretroviral therapy. HIV Med. 2006;7(5):323–30.PubMedCrossRef
41.
Rabeneck L, Palmer A, Knowles JB, et al. A randomized controlled trial evaluating nutrition counseling with or without oral supplementation in malnourished HIV-infected patients. J Am Diet Assoc. 1998;98:434–8.PubMedCrossRef
42.
Berneis K, Battegay M, Bassetti S, et al. Nutritional supplements combined with dietary counselling diminish whole body protein catabolism in HIV-infected patients. Eur J Clin Investig. 2000;30(1):87–94.CrossRef
43.
Saghayam S, Kumarasamy N, Cecelia AJ, Solomon S, Mayer K, Wanke C. Naïve population after 6 months of nevirapine-based generic highly active antiretroviral therapy in South India. Clin Infect Dis. 2007;44:295–300.PubMedCrossRef
44.
Gershwin ME, Borchers AT, Keen CL. Phenotypic and functional considerations in the evaluation of immunity in nutritionally compromised hosts. J Infect Dis. 2000;182(Suppl 1):S108–14.PubMedCrossRef
45.
Najera O, Gonzalez C, Cortes E, Toledo G, Ortiz R. Effector T lymphocytes in well-nourished and malnourished infected children. Clin Exp Immunol. 2007;148(3):501–6.PubMedCrossRef
46.
Savino W, Dardenne M. Nutritional imbalances and infections affect the thymus: consequences on T-cell-mediated immune responses. Proc Nutr Soc. 2010;69(4):636–43.PubMedCrossRef
47.
Chandra RK. Nutrition and immunology: from the clinic to cellular biology and back again. Proc Nutr Soc. 1999;58(3):681–3.PubMedCrossRef
48.
Karsegard VL, Raguso CA, Genton L, Hirschel B, Pichard C. l-ornithine alpha-ketoglutarate in HIV infection: effects on muscle, gastrointestinal, and immune functions. Nutrition. 2004;20(6):515–20.PubMedCrossRef
49.
Keithley JK, Swanson B, Zeller JM, et al. Comparison of standard and immune-enhancing oral formulas in asymptomatic HIV-infected persons: a multicenter randomized controlled clinical trial. JPEN (J Parenter Enter Nutr). 2002;26(1):6–14.CrossRef
50.
Sattler FR, Rajicic N, Mulligan K, et al. Evaluation of high-protein supplementation in weight-stable HIV-positive subjects with a history of weight loss: a randomized, double-blind, multicenter trial. Am J Clin Nutr. 2008;88(5):1313–21.PubMed
51.
Schwenk A, Steuck H, Kremer G. Oral supplements as adjunctive treatment to nutritional counseling in malnourished HIV-infected patients: randomized controlled trial. Clin Nutr. 1999;18(6):371–4.PubMedCrossRef
52.
Shabert JK, Winslow C, Lacey JM, Wilmore DW. Glutamine-antioxidant supplementation increases body cell mass in AIDS patients with weight loss: a randomized, double-blind controlled trial. Nutrition. 1999;15(11–12):860–4.PubMedCrossRef
53.
Swaminathan S, Padmapriyadarsini C, Yoojin L, et al. Nutritional supplementation in HIV-infected individuals in South India: a prospective interventional study. Clin Infect Dis. 2010;51(1):51–7.PubMedCrossRef
Metadata
Title
Impact of Protein Supplementation and Care and Support on Body Composition and CD4 Count Among HIV-Infected Women Living in Rural India: Results from a Randomized Pilot Clinical Trial
Authors
Adeline Nyamathi
Sanjeev Sinha
Kalyan K. Ganguly
Padma Ramakrishna
P. Suresh
Catherine L. Carpenter
Publication date
01-07-2013
Publisher
Springer US
Published in
AIDS and Behavior / Issue 6/2013
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-013-0420-5

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