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Published in: AIDS Research and Therapy 1/2016

Open Access 01-12-2016 | Research

Nutritional status and its effect on treatment outcome among HIV infected clients receiving HAART in Ethiopia: a cohort study

Authors: Sadikalmahdi Hussen, Tefera Belachew, Nezif Hussien

Published in: AIDS Research and Therapy | Issue 1/2016

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Abstract

Purposes

The aim of this study was to determine the effects of nutritional status at the start of highly active anti-retroviral therapy on treatment outcomes among HIV/AIDS patients taking HAART at Jimma University Specialized Hospital.

Methods

We performed a retrospective cohort study involving 340 adults who started highly active anti-retroviral therapy. The patients have been clinically followed for 2 years. Data were extracted from paper based medical charts by trained data collectors from January 30 to February 28, 2014 using data collection format. We entered data into Epi data version 3.1 and then exported to SPSS for windows version 21. Predictors of CD4 change were identified using multivariable linear regression model. Time to an event (death) was estimated by Kaplan–Meier and predictors of mortality were identified by Cox proportional hazard model.

Results

Out of 340 patients, 42 patients died during the follow-up. Twenty-five (59.5 %) deaths were from malnourished group. Age, baseline CD4, sex, baseline HAART and marital status were significant predictors of immunologic recovery at different time points. Malnutrition was associated with lower CD4 recovery and greater hazard of death.

Conclusions

Malnutrition tends to decrease CD4 recovery and predisposes patient to early death.
Literature
1.
go back to reference Palella FJ Jr, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. Lancet. 1998;338:853–60. Palella FJ Jr, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. Lancet. 1998;338:853–60.
2.
go back to reference Valdez H, Chowdhry TK, Asaad R, et al. Changing spectrum of mortality due to human immunodeficiency virus: analysis of 260 deaths during 1995–1999. Clin Infect Dis. 2001;32:1487–93.CrossRefPubMed Valdez H, Chowdhry TK, Asaad R, et al. Changing spectrum of mortality due to human immunodeficiency virus: analysis of 260 deaths during 1995–1999. Clin Infect Dis. 2001;32:1487–93.CrossRefPubMed
3.
go back to reference Floridia M, Fragola V, Galluzzo CM, et al. HIV-related morbidity and mortality in patients starting protease inhibitors in very advanced HIV disease (CD4 count of <50 cells/microL): an analysis of 338 clinical events from a randomized clinical trial. HIV Med. 2002;3:75.CrossRefPubMed Floridia M, Fragola V, Galluzzo CM, et al. HIV-related morbidity and mortality in patients starting protease inhibitors in very advanced HIV disease (CD4 count of <50 cells/microL): an analysis of 338 clinical events from a randomized clinical trial. HIV Med. 2002;3:75.CrossRefPubMed
4.
go back to reference Feldman JG, et al. Serum albumin as a predictor of survival in HIV infected women in the women’s interagency HIV study. AIDS. 2000;14(7):863–70.CrossRefPubMed Feldman JG, et al. Serum albumin as a predictor of survival in HIV infected women in the women’s interagency HIV study. AIDS. 2000;14(7):863–70.CrossRefPubMed
5.
go back to reference Feldman JG, et al. Serum albumin is a powerful predictor of survival among HIV-1-infected women. J Acquir Immune Defic Syndr. 2003;33(1):66–73.CrossRefPubMed Feldman JG, et al. Serum albumin is a powerful predictor of survival among HIV-1-infected women. J Acquir Immune Defic Syndr. 2003;33(1):66–73.CrossRefPubMed
6.
go back to reference Degu Jerene AE, Yewubnesh H, Lindtjørn Bernt. Predictors of early death in a cohort of Ethiopian patients treated with HAART. BMC Infect Dis. 2006;6:136.CrossRefPubMedPubMedCentral Degu Jerene AE, Yewubnesh H, Lindtjørn Bernt. Predictors of early death in a cohort of Ethiopian patients treated with HAART. BMC Infect Dis. 2006;6:136.CrossRefPubMedPubMedCentral
7.
go back to reference Asgeir Johannessen EN, Bernard JN, Leiv S, et al. Predictors of mortality in HIV-infected patients starting antiretroviral therapy in a rural hospital in Tanzania. BMC Infect Dis. 2008;8:52.CrossRefPubMedPubMedCentral Asgeir Johannessen EN, Bernard JN, Leiv S, et al. Predictors of mortality in HIV-infected patients starting antiretroviral therapy in a rural hospital in Tanzania. BMC Infect Dis. 2008;8:52.CrossRefPubMedPubMedCentral
8.
go back to reference Tang AMFJ, Spiegelman D, Knox TA, et al. 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.CrossRefPubMed Tang AMFJ, Spiegelman D, Knox TA, et al. 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.CrossRefPubMed
9.
go back to reference Paton NI, 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.CrossRefPubMed Paton NI, 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.CrossRefPubMed
10.
go back to reference Elizabeth DR, et al. Association of pre-treatment nutritional status with change in CD4 count after antiretroviral therapy at 6, 12, and 24 months in Rwandan women. PLoS ONE. 2011;6(12):e29625.CrossRef Elizabeth DR, et al. Association of pre-treatment nutritional status with change in CD4 count after antiretroviral therapy at 6, 12, and 24 months in Rwandan women. PLoS ONE. 2011;6(12):e29625.CrossRef
12.
go back to reference Brandon RJ, et al. Body mass index and CD4+ T-lymphocyte recovery in HIV infected men with viral suppression on antiretroviral therapy. HIV Clin Trials. 2011;12(4):6. Brandon RJ, et al. Body mass index and CD4+ T-lymphocyte recovery in HIV infected men with viral suppression on antiretroviral therapy. HIV Clin Trials. 2011;12(4):6.
13.
go back to reference Colette J, et al. Factors influencing increases in CD4 cell counts of HIV-positive persons receiving long-term highly active antiretroviral therapy. J Infect Dis. 2004;190:9. Colette J, et al. Factors influencing increases in CD4 cell counts of HIV-positive persons receiving long-term highly active antiretroviral therapy. J Infect Dis. 2004;190:9.
14.
go back to reference Bennett KK, et al. Baseline predictors of CD4 T-lymphocyte recovery with combination antiretroviral therapy. J Acquir Immune Defic Syndr. 2002;31(1):7.CrossRef Bennett KK, et al. Baseline predictors of CD4 T-lymphocyte recovery with combination antiretroviral therapy. J Acquir Immune Defic Syndr. 2002;31(1):7.CrossRef
15.
go back to reference Jean-paul AM, et al. Infulence of age on CD4 cell recovery in human immunodeficiency virus-infected patient’s receiving highly active antiretroviral therapy: evidence from the EuroSIDA study. J Infect Dis. 2001;183(8):5. Jean-paul AM, et al. Infulence of age on CD4 cell recovery in human immunodeficiency virus-infected patient’s receiving highly active antiretroviral therapy: evidence from the EuroSIDA study. J Infect Dis. 2001;183(8):5.
16.
go back to reference Engsig FN, et al. Long-term mortality in HIVpositive individuals virally suppressed for >3 years with incomplete CD4 recovery. Clin Infect Dis. 2014;58(9):10 (Epub 2014 Jan 22).CrossRef Engsig FN, et al. Long-term mortality in HIVpositive individuals virally suppressed for >3 years with incomplete CD4 recovery. Clin Infect Dis. 2014;58(9):10 (Epub 2014 Jan 22).CrossRef
17.
go back to reference Aida YZ, et al. Predictors of suboptimal CD4 response among women achieving virologic suppression in a randomized antiretroviral treatment trial, Africa. BMC Infect Dis. 2014;14(331):1. Aida YZ, et al. Predictors of suboptimal CD4 response among women achieving virologic suppression in a randomized antiretroviral treatment trial, Africa. BMC Infect Dis. 2014;14(331):1.
18.
go back to reference Desta GG, et al. Virologic and immunologic outcome of HAART in Human Immunodeficiency virus (HIV)-1 infected patients with and without tuberculosis (TB) and latent TB infection(LTBI) in Addis Ababa, Ethiopia. AIDS Res Ther. 2013;10(1):1.CrossRef Desta GG, et al. Virologic and immunologic outcome of HAART in Human Immunodeficiency virus (HIV)-1 infected patients with and without tuberculosis (TB) and latent TB infection(LTBI) in Addis Ababa, Ethiopia. AIDS Res Ther. 2013;10(1):1.CrossRef
19.
go back to reference Maskew Mhairi, et al. Poorer ART outcomes with increasing age at a large public sector HIV Clinic in Johannesburg, South Africa. J Int Assoc Phys AIDS Care. 2011;11(1):57–65.CrossRef Maskew Mhairi, et al. Poorer ART outcomes with increasing age at a large public sector HIV Clinic in Johannesburg, South Africa. J Int Assoc Phys AIDS Care. 2011;11(1):57–65.CrossRef
20.
go back to reference Adena H, et al. Effect of age and HAART regimen on clinical response in an urban cohort of HIV infected individuals. AIDS. 2008;22(17):9. Adena H, et al. Effect of age and HAART regimen on clinical response in an urban cohort of HIV infected individuals. AIDS. 2008;22(17):9.
21.
go back to reference Zachariah RFM, Massaquoi M, Pasulani O. Risk factors for high early mortality in patients on antiretroviral treatment in a rural district of Malawi. AIDS. 2006;20(18):2355–60.CrossRefPubMed Zachariah RFM, Massaquoi M, Pasulani O. Risk factors for high early mortality in patients on antiretroviral treatment in a rural district of Malawi. AIDS. 2006;20(18):2355–60.CrossRefPubMed
22.
go back to reference Enju Liu DS, Semu Helen, Hawkins Claudia. Nutritional status and mortality among HIV infected patients receiving antiretroviral therapy in Tanzania. J Infect Dis. 2011;204:282–90.CrossRefPubMed Enju Liu DS, Semu Helen, Hawkins Claudia. Nutritional status and mortality among HIV infected patients receiving antiretroviral therapy in Tanzania. J Infect Dis. 2011;204:282–90.CrossRefPubMed
23.
go back to reference Kelechi N, et al. Determinants of mortality among adult HIV-infected patients on antiretroviral therapy in a rural hospital in Southeastern Nigeria: a 5-year cohort study. AIDS Res Treat 2014;2014:1–6, Article ID 867827. doi:10.1155/2014/867827. Kelechi N, et al. Determinants of mortality among adult HIV-infected patients on antiretroviral therapy in a rural hospital in Southeastern Nigeria: a 5-year cohort study. AIDS Res Treat 2014;2014:1–6, Article ID 867827. doi:10.​1155/​2014/​867827.
24.
go back to reference Kavindhran JL, et al. Comparison of Tenofovir, Zidovudine, or Stavudine as part of first-line antiretroviral therapy in a resource limited-setting: a cohort study. PLoS ONE. 2013;8(5):e64459.CrossRef Kavindhran JL, et al. Comparison of Tenofovir, Zidovudine, or Stavudine as part of first-line antiretroviral therapy in a resource limited-setting: a cohort study. PLoS ONE. 2013;8(5):e64459.CrossRef
25.
go back to reference Parkes-Ratanshi WK, et al. Primary prophylaxis of cryptococcal disease with fluconazole in HIV-positive Ugandan adults: a double-blind, randomised, placebo-controlled trial. Lancet Infect Dis. 2011;11(12):9 (Epub 2011 Oct 6).CrossRef Parkes-Ratanshi WK, et al. Primary prophylaxis of cryptococcal disease with fluconazole in HIV-positive Ugandan adults: a double-blind, randomised, placebo-controlled trial. Lancet Infect Dis. 2011;11(12):9 (Epub 2011 Oct 6).CrossRef
Metadata
Title
Nutritional status and its effect on treatment outcome among HIV infected clients receiving HAART in Ethiopia: a cohort study
Authors
Sadikalmahdi Hussen
Tefera Belachew
Nezif Hussien
Publication date
01-12-2016
Publisher
BioMed Central
Published in
AIDS Research and Therapy / Issue 1/2016
Electronic ISSN: 1742-6405
DOI
https://doi.org/10.1186/s12981-016-0116-9

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