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. 2011 Jul 15;204(2):282-90.
doi: 10.1093/infdis/jir246.

Nutritional status and mortality among HIV-infected patients receiving antiretroviral therapy in Tanzania

Enju Liu  1 , Donna Spiegelman, Helen Semu, Claudia Hawkins, Guerino Chalamilla, Akum Aveika, Stella Nyamsangia, Saurabh Mehta, Deo Mtasiwa, Wafaie Fawzi
Affiliations

Nutritional status and mortality among HIV-infected patients receiving antiretroviral therapy in Tanzania

Enju Liu et al. J Infect Dis. .

Abstract

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.

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