Objective: To evaluate the nutritional intake and status of HIV-1 seropositive patients, as well as the relationship between malnutrition and disease stage. Design: A cross-sectional study. Settings: The Immunology Clinic at the Pelonomi Hospital in Bloemfontein, South Africa. Subjects: Eighty-one HIVaAIDS patients in different stages of disease were recruited consecutively from January to May 1995. Eleven of these patients were followed in 1997. Main outcome measures: Anthropometric data including current weight, height, triceps skinfold thickness, midupper-arm circumference, body mass index and bone-free arm muscle area were collected. Nutrient intake was estimated using a diet history in combination with a standardised food frequency questionnaire. The patients were divided into 3 groups according to their CD4 T cell counts. Results: The men were leaner (BMI 18.9) than the women (BMI 22.7) and patients with a CD4T cell count`200 (stage III) tended to have the lowest median values for all anthropometric measurements. More than half the patients had a low intake (`67% of the recommended dietary allowances) of vitamin C, vitamin B 6 , vitamin D, vitamin A, calcium, iron and zinc. Conclusions: The results con®rms that HIVaAIDS patients from this population are malnourished. There was, however, no association between disease stage and nutritional status. Nutritional supplementation of HIVaAIDS patients should be considered, as this might lead to improved immune function in these patients.
Socio-political factors impacting on access to healthcare most likely had an influence on the referral pattern of patients during this period. The largest group of patients were referred to our institution late in their disease with CRF, often requiring renal replacement therapy, and a definitive diagnosis was seldom possible at that stage. With the limited availability of dialysis facilities, the need for early detection and preventative measures with regard to renal disease in this community is evident.
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