The Investigation of the Use of Prealbumin as a Tool for Nutritional Assessment in Adults Coinfected with HIV and Intestinal Helminth Parasites in KwaZulu-Natal, South Africa

Abstract

Serum prealbumin is considered to be as important as albumin in the nutritional status assessment. However, there is relatively little evidence of its advantage over the commonly used albumin. This study investigated the use of prealbumin compared to albumin as a marker of nutritional status in adults singly and dually infected with human immunodeficiency virus (HIV) and intestinal helminths, with or without inflammatory conditions, in different body mass index (BMI) categories. This cross-sectional study was conducted in a periurban setting in KwaZulu-Natal, South Africa. Multivariate multinomial logistic regression models were fitted to investigate the effect of prealbumin and albumin in nutritional assessment among HIV and helminth individuals with or without inflammation, indicated by elevated and normal C-reactive protein (CRP) levels. In normal CRP, albumin was significantly lower in unadjusted BMI [RRR = 0.8, p = 0.001] and in normal weight [RRR = 0.7, p = 0.003] and overweight [RRR = 0.5, p = 0.001] participants. In elevated CRP, albumin was significantly lower [RRR = 0.8, p = 0.050] and prealbumin was significantly higher in unadjusted BMI [RRR = 1.2, p = 0.034] and overweight [RRR = 1.4, p = 0.052] individuals. The current study found that prealbumin can differentiate between inflammation-induced reduction of albumin and true malnutrition in adults singly or coinfected with HIV and intestinal helminths in the presence or absence of inflammation in various BMI categories.

Association of Serum Prealbumin With Nutritional Status of End-Stage Renal Disease Patients Under Maintenance Hemodialysis

“…Among the anthropometric parameters, BMI showed significant positive correlation with serum prealbumin levels. This is consistent to prior studies, where BMI was shown to have positive correlation with prealbumin level [28][29]. Height and weight showed positive correlation, waist circumference, hip circumference and waist to hip ratio showed negative correlation with serum prealbumin level.…”

Prealbumin as a Predictor of Prognosis in Patients With Coronavirus Disease 2019

“…Although previous studies have found that a series of parameters on admission are correlated with mortality risk (34), there is limited information in the existing literature regarding the relationship between nutrition indexes and disease progression in SARS-CoV-2-infected patients. Several studies have reported the value of nutritional indicators represented by PAB on determining the severity of viral infections and predicting the prognosis of patients (35,36). In addition, there is some literature describing the roles of inflammatory indicators (hsCRP and PCT), coagulation indicators (DD), and the number of lymphocytes in monitoring the disease progression during viral infection and prediction of disease outcome (36)(37)(38).…”

Immunological interaction during helminth and HIV co-infection: Integrative research needs for sub-Saharan Africa

“…23 The association between HIV and helminth co-infections and lower biochemical micronutrients, protein and carbohydrate levels in humans has also been shown. 24 Additionally, several nutrient deficiencies have been found to increase the likelihood of HIV and helminth co-infection. 24 It is understood that various nutrient deficiencies cause impaired immunity.…”

“…24 Additionally, several nutrient deficiencies have been found to increase the likelihood of HIV and helminth co-infection. 24 It is understood that various nutrient deficiencies cause impaired immunity. 23 These findings illustrate the need for further research that may better describe and explain the effects of helminth immune modulation in individuals co-infected with HIV, leading to successful development of helminth and HIV-related vaccines which will be effective and timely accessible to save lives and improve the general health of those co-infected.…”