Nutritional Status and Quality of Life of Women with HIV/AIDS

Abstract

Problem statement:HIV infection is a multisystem disorder which causes chronic infections that lead to profound immune-suppression. Women have always been a vulnerable section of the society. They are doubly vulnerable due to the HIV and malnutrition vicious cycle, which may affect their Quality Of Life (QOL). There are different literature reviews which suggest undernutrition, wasting due to HIV but it is important to know whether this under-nutrition affects their Quality Of Life (QOL) of these vulnerable women. Approach: This cross sectional study recruited female patients on antiretroviral therapy. Weight, height, grip strength, Tricep Skin Fold (TSF) and Mid Upper Arm Circumference (MUAC) were measured. Nutrient intake was calculated by 24 h recall and food frequency questionnaire. WHO QOL-HIV BREF was used to assess QOL. Results: Among 55 patients, 32 (58.2%), 23 (41.8%) were asymptomatic and symptomatic respectively. The mean adequacies of energy and protein for all the subjects were 57.56 ± 21.89, 61.27 ± 28.50 percent respectively. The Body Mass Index (BMI) of the symptomatic were significantly (p = 0.009) lower than the asymptomatic subjects, the mean being 19.84 ± 3.6 (kg/m²), with 27.3% having BMI < 18.5 (kg/m²). The mean TSF, MUAC, grip strength and hemoglobin level were 10.66 ± 4.36 mm, 23.72 ± 3.43 cm, 16.12 ± 5.03 kg force and 10.8 ± 1.3g/dl respectively. The scores of QOL were correlated positively with all the parameters of nutritional status. Grip strength and hemoglobin level were significantly correlated (p = 0.01) with the scores of four and five domains of QOL respectively. Conclusion: Dietary intake was inadequate, which affected the nutritional status. Conservation of muscle mass and maintenance of hemoglobin levels may improve QOL in HIV infected women. Thus there is a need for nutritional counseling and other nutritional intervention.

Gender difference in health related quality of life and associated factors among people living with HIV/AIDS attending anti-retroviral therapy at public health facilities, western Ethiopia: comparative cross sectional study

“…This finding was supported by the study from Nepal [17] and India [36]; that showed most of health related quality of life domains of PLWHA were significantly decreased as body mass index lowered. A study from South Africa also found that physical and independence health were affected by daily energy intake [10].…”

Measures of Nutritional Status and Quality of Life in Adult People Living with HIV/AIDS at a Tertiary Hospital in Nigeria

“…Improvement in nutritional status was in terms of improvement in SGA or MUST score and weight gained or lost. However, no consensus has been reached at the moment on the actual influence that nutrition plays in quality of life in PLWHA [7]. The current study, thus aimed at further investigating the relationship between nutritional assessment parameters and quality of life in a cohort of HIV-seropositive patients and identifying nutritional variables that best predicts weight loss.…”

“…Quality of life (QOL) also plays an important aspect in the overall care of PLWHA. World Health Organization (WHO) has defined QOL as an individuals' perception of their position in life in the context of their culture and value system in which they "live and in relation to their goals, standards, expectations and concerns" [5]- [7]. The 26-item WHOQOL-Bref, is a validated tool that measures quality of life in PLWHA in four different domains: 1) physical domain (assesses the individual's perception of impact of disease on the activities of daily living, dependence on medication, lack of energy and initiative, restricted mobility and capacity to work); 2) psychological domain (assesses the individual's satisfaction with thoughts about body image and appearance, negative feelings, positive feelings, self-esteem and personal beliefs); 3) social relations (assesses personal relationships, social support and sexual activity); 4) environmental domain (assesses satisfaction with financial resources, work environment, accessibility to health and social care, freedom, security, participation and opportunities for leisure activities) [8].…”

“…An important goal of therapy in HIV infection is to improve nutritional status, as well as quality of life. However, the relationship between nutritional status and quality of life is not well defined [7]. Person living with HIVAIDS (PLWHA) often develops gastrointestinal symptoms like change in taste, smell, nausea and vomiting resulting in reduced dietary intake.…”

“…Only a few studies have described the relationship between nutritional status and quality of life in PLWHA. Bhowmik et al, (2012) [7] reported improvement in QOL upon maintenance of hemoglobin levels and conservation of muscle mass [7]. Some studies reported positive correlation between the quality of life scores and CD4 count [13]- [17], and nutritional status parameters like the weight, BMI, handgrip strength, haemoglobin, and mid-upper arm circumference [7].…”