TY - JOUR
T1 - Nutritional status and mortality among HIV-infected patients receiving antiretroviral therapy in Tanzania
AU - Liu, Enju
AU - Spiegelman, Donna
AU - Semu, Helen
AU - Hawkins, Claudia
AU - Chalamilla, Guerino
AU - Aveika, Akum
AU - Nyamsangia, Stella
AU - Mehta, Saurabh
AU - Mtasiwa, Deo
AU - Fawzi, Wafaie
N1 - Funding Information:
This program is supported by the United States President’s Emergency Plan for AIDS Relief through the Harvard School of Public Health and by the Ministry of Health and Social Welfare, Tanzania.
PY - 2011/7/15
Y1 - 2011/7/15
N2 - Background. Poor nutritional status is associated with immunologic impairment and adverse health outcomes among adults infected with human immunodeficiency virus (HIV). Methods. We investigated body mass index (BMI), middle upper arm circumference (MUAC), and hemoglobin (Hgb) concentrations at initiation of antiretroviral therapy (ART) in 18,271 HIV-infected Tanzanian adults and their changes in the first 3 months of ART, in relation to the subsequent risk of death. Results. Lower BMI, MUAC, and Hgb concentrations at ART initiation were strongly associated with a higher risk of death within 3 months. Among patients who survived >3 months after ART initiation, those with a decrease in weight, MUAC, or Hgb concentrations by 3 months had a higher risk of death during the first year. After 1 year, only a decrease in MUAC by 3 months after ART initiation was associated with a higher risk of death. Weight loss was associated with a higher risk of death across all levels of baseline BMI, with the highest risk observed among patients with BMI <17 kg/m 2 (relative risk, 7.9; 95% confidence interval, 4.4-14.4). Conclusions. Poor nutritional status at ART initiation and decreased nutritional status in the first 3 months of ART were strong independent predictors of mortality. The role of nutritional interventions as adjunct therapies to ART merits further investigation.
AB - Background. Poor nutritional status is associated with immunologic impairment and adverse health outcomes among adults infected with human immunodeficiency virus (HIV). Methods. We investigated body mass index (BMI), middle upper arm circumference (MUAC), and hemoglobin (Hgb) concentrations at initiation of antiretroviral therapy (ART) in 18,271 HIV-infected Tanzanian adults and their changes in the first 3 months of ART, in relation to the subsequent risk of death. Results. Lower BMI, MUAC, and Hgb concentrations at ART initiation were strongly associated with a higher risk of death within 3 months. Among patients who survived >3 months after ART initiation, those with a decrease in weight, MUAC, or Hgb concentrations by 3 months had a higher risk of death during the first year. After 1 year, only a decrease in MUAC by 3 months after ART initiation was associated with a higher risk of death. Weight loss was associated with a higher risk of death across all levels of baseline BMI, with the highest risk observed among patients with BMI <17 kg/m 2 (relative risk, 7.9; 95% confidence interval, 4.4-14.4). Conclusions. Poor nutritional status at ART initiation and decreased nutritional status in the first 3 months of ART were strong independent predictors of mortality. The role of nutritional interventions as adjunct therapies to ART merits further investigation.
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U2 - 10.1093/infdis/jir246
DO - 10.1093/infdis/jir246
M3 - Article
C2 - 21673040
AN - SCOPUS:79958745850
SN - 0022-1899
VL - 204
SP - 282
EP - 290
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 2
ER -
