BACKGROUND: Wasting is a strong independent predictor of mortality in HIV-infected persons. Vitamin supplements delay the disease progression, but their effect on wasting is not known. Data are lacking on the risk factors for wasting in African HIV-infected persons. OBJECTIVES: The objectives were to examine the effect of vitamin supplements on wasting in HIV-infected women and to assess the effects of sociodemographic characteristics, morbidity events, and immunologic progression on the risk of wasting. DESIGN:HIV-infected women (n = 1078) from Tanzania were randomly assigned to receive 1 of 4 daily oral regimens: multivitamins (B complex, C, and E), vitamin A plus beta-carotene, multivitamins that included vitamin A plus beta-carotene, or placebo. The endpoints of the study included first episodes of a midupper arm circumference <22 cm or a body mass index (BMI; in kg/m2) <18 and the incidence of weight loss episodes during a median 5.3 y of follow-up. RESULTS: Multivitamins alone significantly reduced the risk of a first episode of a midupper arm circumference <22 cm (relative risk: 0.66; 95% CI: 0.47, 0.94; P = 0.02). In multivariate-adjusted Cox models, the woman's age, education level, and height were inversely related to the incidence of wasting. Episodes of diarrhea, nausea or vomiting, lower respiratory tract infections, oral ulcers, thrush, severe anemia, and low CD4+ cell counts were each significantly related to an increased risk of wasting. CONCLUSIONS:Vitamins C and E and the vitamin B complex have a protective effect on wasting in HIV-infected women. Prevention of diarrhea, severe respiratory tract infections, and anemia are likely to decrease the burden of wasting.
RCT Entities:
BACKGROUND: Wasting is a strong independent predictor of mortality in HIV-infectedpersons. Vitamin supplements delay the disease progression, but their effect on wasting is not known. Data are lacking on the risk factors for wasting in African HIV-infectedpersons. OBJECTIVES: The objectives were to examine the effect of vitamin supplements on wasting in HIV-infectedwomen and to assess the effects of sociodemographic characteristics, morbidity events, and immunologic progression on the risk of wasting. DESIGN:HIV-infectedwomen (n = 1078) from Tanzania were randomly assigned to receive 1 of 4 daily oral regimens: multivitamins (B complex, C, and E), vitamin A plus beta-carotene, multivitamins that included vitamin A plus beta-carotene, or placebo. The endpoints of the study included first episodes of a midupper arm circumference <22 cm or a body mass index (BMI; in kg/m2) <18 and the incidence of weight loss episodes during a median 5.3 y of follow-up. RESULTS: Multivitamins alone significantly reduced the risk of a first episode of a midupper arm circumference <22 cm (relative risk: 0.66; 95% CI: 0.47, 0.94; P = 0.02). In multivariate-adjusted Cox models, the woman's age, education level, and height were inversely related to the incidence of wasting. Episodes of diarrhea, nausea or vomiting, lower respiratory tract infections, oral ulcers, thrush, severe anemia, and low CD4+ cell counts were each significantly related to an increased risk of wasting. CONCLUSIONS: Vitamins C and E and the vitamin B complex have a protective effect on wasting in HIV-infectedwomen. Prevention of diarrhea, severe respiratory tract infections, and anemia are likely to decrease the burden of wasting.
Authors: Saurabh Mehta; Ferdinand M Mugusi; Donna Spiegelman; Eduardo Villamor; Julia L Finkelstein; Ellen Hertzmark; Edward L Giovannucci; Gernard I Msamanga; Wafaie W Fawzi Journal: AIDS Patient Care STDS Date: 2011-09-14 Impact factor: 5.078
Authors: Julia L Finkelstein; Heather S Herman; Albert Plenty; Saurabh Mehta; Paul Natureeba; Tamara D Clark; Moses R Kamya; Theodore Ruel; Edwin D Charlebois; Deborah Cohan; Diane Havlir; Sera L Young Journal: Curr Dev Nutr Date: 2020-04-25