Effects of nutrition counseling and monitoring on the weight and hemoglobin of patients receiving antiretroviral therapy in Ebonyi State, Southeast Nigeria

Abstract

IntroductionThe relationship between human immunodeficiency virus (HIV) and malnutrition is easily explained, and the etiology of malnutrition in HIV disease is believed to be multifactorial.It therefore follows that ongoing assessment of nutritional and medical status is crucial to quality nutrition care for every person living with HIV. The aim of this study was to find out the effect of nutritional counseling and monitoring, using personalized dietary prescriptions, on the body mass index (BMI) and hemoglobin of patients who are HIV-infected and also receiving highly active antiretroviral drugs.MethodsA total of 84 patients were selected using simple random sampling and allocated into intervention and control groups. Nutritional counseling and monitoring was done for the intervention group, while only weight, height, and hemoglobin concentration were monitored for the control group. At the end of 6 months, the differences in mean body mass index (BMI) and hemoglobin concentrations of the intervention and control groups were compared using the Student’s t-test. Statistical level of significance was put at P<0.05.ResultsAmong respondents, 30.96% were males and 69.04% were females, and the mean age of the intervention group was 33.8 years and was 35.3 in the control group. After 6 months of study, the difference in the mean BMI among the males of both groups (24.9 kg/m2 [intervention] and 24.3 kg/m2 [control]) was not significant (P=0.53) but was significant among the females (24.9 kg/m2 [intervention group] versus 21.8 kg/m2 [control group]) (P=0.0005). The difference in mean hemoglobin concentration between the intervention and control groups for both males and females were statistically significant (12.2 mg/dL for males in the intervention group and 11.0 mg/dL for males in the control group [P=0.005]; 11.9 mg/dL for females in the intervention group and 11.0 mg/dL for females in the control group [P=0.010ConclusionNutrition intervention is important in the management of people living with HIV/acquired immunodeficiency disease (AIDS) while on antiretroviral therapy. This can be achieved through nutritional counseling and monitoring.

Nutrition Assessment, Counseling, and Support Interventions to Improve Health-Related Outcomes in People Living With HIV/AIDS

“…29 One of these studies was an RCT in Nigeria comparing six months of nutrition counseling to a control group who were not provided nutrition counseling. The authors reported a significantly higher hemoglobin concentration in participants who were assigned to monthly, individualized dietary and food hygiene counseling sessions compared to controls (12.1 vs. 11.2 mg/dL, p=0.0015), 31 suggesting that individualized counseling to improve intake of iron-rich foods that are locally available and affordable can help to improve or prevent HIV-related anemia. In Uganda, Rawat et al found no effect of food supplementation on hemoglobin concentrations in the overall cohort, but reported a more significant impact among the subset of individuals with CD4 counts >350 cells/mm 3 29 .…”

“…These outcomes included effects on hemoglobin concentrations, 29,31 number of severe clinical events (including hospitalizations and death), 23 change in WHO stage, 24,32 and number of self-reported HIV-related symptoms. 29 One of these studies was an RCT in Nigeria comparing six months of nutrition counseling to a control group who were not provided nutrition counseling.…”

The impact of nutritional status and nutrition supplementation on outcomes along the HIV treatment cascade in the resource-limited setting

“…The BMI of both men and women increased in the intervention group; there was no change in the control group. There were significantly greater increases in hemoglobin in the intervention group as compared with the control group [20].…”

Growth in children infected with HIV receiving anti‐retroviral therapy in Vietnam

“…The intercorrelation between these two factors might represent the fact that they are both dependent on the level of nutrition intake: poor nutrition absorbance could be a consequence viral replication and disturbance of the immune system, especially in the mucosa, and a side‐effect of ART . Alo et al . showed that nutrition intervention could improve the growth parameters as well as the anemia status of HIV‐infected children treated with ART in South East Nigeria, suggesting that these two factors were both associated with the nutrition status of HIV‐infected children.…”