Under Nutrition and Its Use in Prediction of Immunodeficiency in Adults Infected with Human Immunodeficiency Virus in Addis Ababa-Ethiopia

Abstract

HIV infection and poor nutrition status are interlinked. HIV infected individuals are more vulnerable to under nutrition than the general population. Despite major advances in HIV treatment and survival outcomes, weight loss and wasting remain of significant health concern in people living with HIV. Poor nutritional status in HIV infected individuals is associated with disease progression, increased morbidity and reduced survival even when antiretroviral treatment (ART) is available. HIV and malnutrition have a cumulative effect in weakening the immune system and worsening nutrition status. The objective of this study was to assess the prevalence of under nutrition (wasting) among HIV infected, antiretroviral naïve adults, and the utility of wasting in predicting immunosuppression in Addis Ababa, Ethiopia, 2014. Institution based, cross sectional study was done on a sample of 395 antiretroviral naïve adults attending chronic HIV care programs. Study participants were selected by systematic random sampling. Data was collected using a structured interview questionnaire and anthropometric measurements (weight and height) were taken from all study participants. CD4 cell count was done using standard laboratory method and used as a proxy indicator of immune status. Body mass index (BMI) was correlated with CD4 cell count and receiver operating characteristic curves plotted. Under nutrition was of critical health concern among HIV infected antiretroviral naïve adults. The study showed a 27% prevalence of wasting with significantly variation by sex. More women were malnourished than men. There was significant association between wasting and immune suppression. However, the sensitivity and specificity of wasting to predict stages of immune suppression was low. HIV infected individuals need special attention for nutrition monitoring, counselling and support.