BACKGROUND: Poor nutritional status is associated with immunologic impairment and adverse health outcomes among adults infected with human immunodeficiency virus (HIV). METHODS: We investigated body mass index (BMI), middle upper arm circumference (MUAC), and hemoglobin (Hgb) concentrations at initiation of antiretroviral therapy (ART) in 18,271 HIV-infected Tanzanian adults and their changes in the first 3 months of ART, in relation to the subsequent risk of death. RESULTS: Lower BMI, MUAC, and Hgb concentrations at ART initiation were strongly associated with a higher risk of death within 3 months. Among patients who survived >3 months after ART initiation, those with a decrease in weight, MUAC, or Hgb concentrations by 3 months had a higher risk of death during the first year. After 1 year, only a decrease in MUAC by 3 months after ART initiation was associated with a higher risk of death. Weight loss was associated with a higher risk of death across all levels of baseline BMI, with the highest risk observed among patients with BMI <17 kg/m(2) (relative risk, 7.9; 95% confidence interval, 4.4-14.4). CONCLUSIONS: Poor nutritional status at ART initiation and decreased nutritional status in the first 3 months of ART were strong independent predictors of mortality. The role of nutritional interventions as adjunct therapies to ART merits further investigation.
BACKGROUND: Poor nutritional status is associated with immunologic impairment and adverse health outcomes among adults infected with human immunodeficiency virus (HIV). METHODS: We investigated body mass index (BMI), middle upper arm circumference (MUAC), and hemoglobin (Hgb) concentrations at initiation of antiretroviral therapy (ART) in 18,271 HIV-infected Tanzanian adults and their changes in the first 3 months of ART, in relation to the subsequent risk of death. RESULTS: Lower BMI, MUAC, and Hgb concentrations at ART initiation were strongly associated with a higher risk of death within 3 months. Among patients who survived >3 months after ART initiation, those with a decrease in weight, MUAC, or Hgb concentrations by 3 months had a higher risk of death during the first year. After 1 year, only a decrease in MUAC by 3 months after ART initiation was associated with a higher risk of death. Weight loss was associated with a higher risk of death across all levels of baseline BMI, with the highest risk observed among patients with BMI <17 kg/m(2) (relative risk, 7.9; 95% confidence interval, 4.4-14.4). CONCLUSIONS: Poor nutritional status at ART initiation and decreased nutritional status in the first 3 months of ART were strong independent predictors of mortality. The role of nutritional interventions as adjunct therapies to ART merits further investigation.
Authors: Ajibola I Abioye; Sheila Isanaka; Enju Liu; Ramadhani S Mwiru; Ramadhani A Noor; Donna Spiegelman; Ferdinand Mugusi; Wafaie Fawzi Journal: AIDS Care Date: 2015-01-06
Authors: Charitha Gowda; Todd T Brown; Charlene Compher; Kimberly A Forde; Jay Kostman; Pamela A Shaw; Phyllis C Tien; Vincent Lo Re Journal: AIDS Date: 2016-10-23 Impact factor: 4.177
Authors: Helen Semu; Rachel M Zack; Enju Liu; Ellen Hertzmark; Donna Spiegelman; Kevin Sztam; Claudia Hawkins; Guerino Chalamila; Aisa Muya; Hellen Siril; Ramadhani Mwiru; Deo Mtasiwa; Wafaie Fawzi Journal: J Int Assoc Provid AIDS Care Date: 2014-08-21
Authors: M Bakari; J Wamsele; T MacKenzie; I Maro; J Kimario; S Ali; S Dowla; K Hendricks; Z Lukmanji; N M Neke; R Waddell; M Matee; K Pallangyo; C F von Reyn Journal: Public Health Action Date: 2013-09-21
Authors: Ramadhani A Noor; Ajibola I Abioye; Ellen Hertzmark; Anne M Darling; Said Aboud; Ferdinand M Mugusi; Christopher R Sudfeld; Donna Spiegelman; Wafaie W Fawzi Journal: J Nutr Date: 2020-09-01 Impact factor: 4.798
Authors: Lauren S Peetluk; Peter F Rebeiro; Marcelo Cordeiro-Santos; Afranio Kritski; Bruno B Andrade; Betina Durovni; Solange Calvacante; María B Arriaga; Megan M Turner; Marina C Figueiredo; Valeria C Rolla; Timothy R Sterling Journal: J Infect Dis Date: 2020-04-07 Impact factor: 5.226
Authors: Anne F Luetkemeyer; Susan L Rosenkranz; Darlene Lu; Florence Marzan; Prudence Ive; Evelyn Hogg; Susan Swindells; Constance A Benson; Beatriz Grinsztejn; Ian M Sanne; Diane V Havlir; Francesca Aweeka Journal: Clin Infect Dis Date: 2013-04-16 Impact factor: 9.079
Authors: Ramadhani S Mwiru; Donna Spiegelman; Christopher Duggan; George R Seage; Helen Semu; Guerino Chalamilla; Rodrick Kisenge; Wafaie W Fawzi Journal: J Int Assoc Provid AIDS Care Date: 2013-10-08