Prevalence of hypoalbuminemia in outpatients with HIV/AIDS

Leal, José Adalberto; Fausto, Maria Arlene; Carneiro, Mariângela; Tubinambás, Unaí

doi:10.1590/0037-8682-0093-2017

Cited by 12 publications

(10 citation statements)

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“…Regarding the correlation between ART response and the studied nutritional parameters, albumin, NRI, total protein and total cholesterol were independent factors correlating with plasma viral load. Of note, albuminemia is likely to vary with inflammatory response, renal and hepatic functions in the course of HIV infection [ 44 ]. Furthermore, albumin and pre-albumin are often used as indicators of nutritional status, while albumin represents a key component of the NRI that serves for an in-depth evaluation of the nutritional profile [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, it seems at least as likely that socioeconomically vulnerable individuals with food insecurity also have worse ART adherence [ 46 – 48 ], while an increased viral load is also known to impair cholesterol level [ 38 ]. This observation suggests an interaction between HIV and cholesterol, which might lead to metabolic abnormalities (lipodystrophy, dyslipidemia, diabetes mellitus, and insulin resistance) prone by HIV itself and/or antiretroviral agents [ 44 ]. Finally, correlation between viral load and total cholesterol suggests that the latter may play a role in HIV life cycle owing to lipid functions in viral entry, uncoating, replication, protein synthesis, assembly, budding and infectivity [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

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Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

et al. 2021

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Background HIV management remains concerning and even more challenging in the frame of comorbidities like malnutrition that favors disease progression and mortality in resource-limited settings (RLS). Objective To describe the nutritional parameters of antiretroviral therapy (ART) recipients (without nutritional support) with respect to CD4 count and virological failure. Methods A cross-sectional study was conducted from October to December 2018 among 146 consenting participants enrolled in two health facilities of the East-Region of Cameroon. Socio-demographic data, basic clinical information and treatment history were collected; blood samples were collected by venipuncture for laboratory analysis (HIV-1 viral load, CD4 Tcells measurement and biochemical analysis) performed at the “Chantal Biya” International Reference Center”, Yaounde, Cameroon. The nutritional profile was assessed by using anthropometric and biochemical parameters. Data were analyzed using Excel 2016, Graph pad prism version 6; Spearman correlation and Kruskal-Wallis test were used; with p<0.05 considered statistically significant. Results Median [IQR] age was 42 [33–51] years, 76.0% (111/146) were female and median [IQR] duration on ART was 54 [28–86] months. Of these participants, 11.6% (17/146) were underweight based on the body mass index and 4.7% (7/146) were at the stage of advanced weight loss. According to immunovirological responses, 44.5% (65/146) were immunocompromised (CD4<500 cell/μl) and 75.3% (110/146) had an undetectable viremia (<40 copies/mL). CD4 count inversely correlated with total protein concentration (r = -0.18, p = 0.005**). Viremia was inversely correlated with albumin (r = -0.21; p = 0.047*), nutritional risk index (r = -0.28; p = 0.013*), total cholesterol (r = -0.27; p = 0.007**), and positively correlated with total protein (r = 0.27; p<0.001**) concentrations. Conclusion In this RLS, with patients having about five years of ART-experience, malnutrition appears to be driven mainly by a poor BMI, indicating that about one of ten patients falls within this severe condition. However, the largely normal nutritional profiles should be interpreted with caution, considering local realities and food support programs in place. The present outcomes highlight the need for monitoring nutritional status of people receiving ART in RLS, toward the design of optimal food interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

et al. 2021

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“…The prognostic value of low serum albumin levels has been demonstrated not only for the development and complications of acute viral, bacterial, and fungal infections [ 95 ], but also for infectious complications in chronic conditions including malignant diseases [ 66 , 96 ], chronic inflammatory diseases [ 97 , 98 ], diabetes [ 95 ], hemodialysis [ 99 ], and solid organ transplantation [ 100 ]. In chronic infectious diseases, hypoalbuminemia is associated with disease reactivation/recurrence and secondary infections [ 101 , 102 , 103 ].…”

Section: Hypoalbuminemia and Prognosis In Infectionsmentioning

confidence: 99%

Hypoalbuminemia as Surrogate and Culprit of Infections

Wiedermann¹

2021

IJMS

118

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Hypoalbuminemia is associated with the acquisition and severity of infectious diseases, and intact innate and adaptive immune responses depend on albumin. Albumin oxidation and breakdown affect interactions with bioactive lipid mediators that play important roles in antimicrobial defense and repair. There is bio-mechanistic plausibility for a causal link between hypoalbuminemia and increased risks of primary and secondary infections. Serum albumin levels have prognostic value for complications in viral, bacterial and fungal infections, and for infectious complications of non-infective chronic conditions. Hypoalbuminemia predicts the development of healthcare-associated infections, particularly with Clostridium difficile. In coronavirus disease 2019, hypoalbuminemia correlates with viral load and degree of acute lung injury and organ dysfunction. Non-oncotic properties of albumin affect the pharmacokinetics and pharmacodynamics of antimicrobials. Low serum albumin is associated with inadequate antimicrobial treatment. Infusion of human albumin solution (HAS) supplements endogenous albumin in patients with cirrhosis of the liver and effectively supported antimicrobial therapy in randomized controlled trials (RCTs). Evidence of the beneficial effects of HAS on infections in hypoalbuminemic patients without cirrhosis is largely observational. Prospective RCTs are underway and, if hypotheses are confirmed, could lead to changes in clinical practice for the management of hypoalbuminemic patients with infections or at risk of infectious complications.

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“…Hypoalbuminemia is an independent predictor of mortality in both compensated and decompensated cirrhosis, AIDS, diabetes and chronic kidney disease [17][18][19][20]. Previous studies indicated that serum cholinesterase is an important clinical marker of inflammation and reduced serum cholinesterase indicates severe systemic inflammation in critically ill patients [21,22].…”

Section: Discussionmentioning

confidence: 99%

Immune status affects the clinical features and outcomes of adult patients with respiratory adenovirus infection

et al. 2021

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The differences in the clinical features and outcomes of respiratory adenovirus infection (RAI) between immunocompetent and immunocompromised adult patients remain unclear. Thirty-nine adult RAI patients, including 28 (71.8%) immunocompetent patients and 11 (28.2%) immunocompromised patients were enrolled in this retrospective study. Demographic characteristics, symptoms, laboratory tests, radiographic findings, therapies and clinical outcomes were compared between the two groups. We found fever (94.9%), cough (66.7%) and sputum production (56.4%) were the most frequent symptoms. Compared with immunocompetent RAI patients, the immunocompromised RAI patients were more likely to experience anemia (g/L; 90.8 ± 24.0 vs 134.3 ± 14.6, P ＜ 0.001), thrombocytopenia (×10 9 /L; 116.9 ± 92.7 vs 178.4 ± 74.6, P = 0.037), hypoalbuminemia (g/L; 29.6 ± 5.5 vs 36.9 ± 5.2, P ＜ 0.001), hyponatremia (mmol/L; 134.8 ± 5.6 vs 138.5 ± 3.9, P = 0.026) and low levels of cholinesterase (U/L; 2650.5 ± 1467.4 vs 5892.8 ± 1875.1, P ＜ 0.001). Chest computed tomography (CT) scans indicated that lung infiltrate was the most common finding (64.1%).Immunocompromised patients had a higher likelihood of bilateral lung involvement (72.7%) and lower lobe involvement (81.8%) of both lungs. The hospitalized mortality rate was 27.3% in immunocompromised RAI patients, but no deaths

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Prevalence of hypoalbuminemia in outpatients with HIV/AIDS

Abstract: The monitoring of plasma albumin is key to determine when antiretroviral therapy should be initiated in individuals not exposed to antiretroviral medicines.

Cited by 12 publications

References 10 publications

Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

Hypoalbuminemia as Surrogate and Culprit of Infections

Immune status affects the clinical features and outcomes of adult patients with respiratory adenovirus infection

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