Hyejeong Hong1, Chakra Budhathoki2, Jason E Farley3. 1. Johns Hopkins University School of Nursing, Department of Community-Public Health, 525 North Wolfe Street, Baltimore, MD, 21205, USA; Johns Hopkins University School of Nursing, The REACH Initiative, 1909 McElderry Street, SON House, Baltimore, MD, 21205, USA. Electronic address: hhong13@jhu.edu. 2. Johns Hopkins University School of Nursing, Department of Acute and Chronic Care, 525 North Wolfe Street, Baltimore, MD, 21205, USA. Electronic address: cbudhat1@jhu.edu. 3. Johns Hopkins University School of Nursing, Department of Community-Public Health, 525 North Wolfe Street, Baltimore, MD, 21205, USA; Johns Hopkins University School of Nursing, The REACH Initiative, 1909 McElderry Street, SON House, Baltimore, MD, 21205, USA. Electronic address: jfarley1@jhu.edu.
Abstract
BACKGROUND & AIMS: Malnutrition is common in Sub-Saharan Africa, weakening the immune function of persons living with HIV infection (PLWH). Being malnourished at the initiation of antiretroviral therapy (ART) leads to higher risk of early mortality and reduced quality of life. Thus, introduction of protein-energy-fortified macronutrient supplements at ART initiation may improve HIV treatment outcomes. This review aimed to evaluate the effectiveness of macronutrient interventions. METHODS: This systematic review and meta-analysis included 15 studies conducted from 2000 to 2015 among Sub-Saharan African adults. RESULTS: Six randomized controlled trials and 4 retrospective cohort studies provided data eligible for a meta-analysis. Supplementation significantly increased the overall standardized mean difference (SMD) between baseline and follow-up data in weight (SMD = 0.382, p < .001), BMI (SMD = 0.799, p < .001); fat-free mass (SMD = 0.154, p = .009); and CD4 count (SMD = 0.428, p < .001). CONCLUSION: Protein-energy-fortified macronutrient supplementation at ART initiation may positively influence nutritional status and immunologic response in PLWH in Sub-Saharan Africa.
BACKGROUND & AIMS:Malnutrition is common in Sub-Saharan Africa, weakening the immune function of persons living with HIV infection (PLWH). Being malnourished at the initiation of antiretroviral therapy (ART) leads to higher risk of early mortality and reduced quality of life. Thus, introduction of protein-energy-fortified macronutrient supplements at ART initiation may improve HIV treatment outcomes. This review aimed to evaluate the effectiveness of macronutrient interventions. METHODS: This systematic review and meta-analysis included 15 studies conducted from 2000 to 2015 among Sub-Saharan African adults. RESULTS: Six randomized controlled trials and 4 retrospective cohort studies provided data eligible for a meta-analysis. Supplementation significantly increased the overall standardized mean difference (SMD) between baseline and follow-up data in weight (SMD = 0.382, p < .001), BMI (SMD = 0.799, p < .001); fat-free mass (SMD = 0.154, p = .009); and CD4 count (SMD = 0.428, p < .001). CONCLUSION: Protein-energy-fortified macronutrient supplementation at ART initiation may positively influence nutritional status and immunologic response in PLWH in Sub-Saharan Africa.
Authors: Lakshmi Murthy; Sasha Shepperd; Mike J Clarke; Sarah E Garner; John N Lavis; Laure Perrier; Nia W Roberts; Sharon E Straus Journal: Cochrane Database Syst Rev Date: 2012-09-12
Authors: Mette F Olsen; Alemseged Abdissa; Pernille Kæstel; Markos Tesfaye; Daniel Yilma; Tsinuel Girma; Jonathan C K Wells; Christian Ritz; Christian Mølgaard; Kim F Michaelsen; Dilnesaw Zerfu; Søren Brage; Ase B Andersen; Henrik Friis Journal: BMJ Date: 2014-05-15
Authors: M Azabji-Kenfack; S Edie Dikosso; E G Loni; E A Onana; E Sobngwi; E Gbaguidi; A L Ngougni Kana; G Nguefack-Tsague; D Von der Weid; O Njoya; J Ngogang Journal: Nutr Metab Insights Date: 2011-05-02