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. 2021 May 13;16(5):e0229550.
doi: 10.1371/journal.pone.0229550. eCollection 2021.

Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

Aissatou Abba  1   2 , Joseph Fokam  1   2   3   4 , Rachel Simo Kamgaing  1 , Junie Flore Yimga  1 , Aude Christelle Ka'e  1 , Alex Durand Nka  1 , Michel Carlos Tommo Tchouaket  1   2 , Collins Ambe Chenwi  1 , Ezechiel Ngoufack Jagni Semengue  1 , Alexis Ndjolo  1   4 , Samuel Martin Sosso  1
Affiliations

Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

Aissatou Abba et al. PLoS One. .

Abstract

Background: HIV management remains concerning and even more challenging in the frame of comorbidities like malnutrition that favors disease progression and mortality in resource-limited settings (RLS).

Objective: To describe the nutritional parameters of antiretroviral therapy (ART) recipients (without nutritional support) with respect to CD4 count and virological failure.

Methods: A cross-sectional study was conducted from October to December 2018 among 146 consenting participants enrolled in two health facilities of the East-Region of Cameroon. Socio-demographic data, basic clinical information and treatment history were collected; blood samples were collected by venipuncture for laboratory analysis (HIV-1 viral load, CD4 Tcells measurement and biochemical analysis) performed at the "Chantal Biya" International Reference Center", Yaounde, Cameroon. The nutritional profile was assessed by using anthropometric and biochemical parameters. Data were analyzed using Excel 2016, Graph pad prism version 6; Spearman correlation and Kruskal-Wallis test were used; with p<0.05 considered statistically significant.

Results: Median [IQR] age was 42 [33-51] years, 76.0% (111/146) were female and median [IQR] duration on ART was 54 [28-86] months. Of these participants, 11.6% (17/146) were underweight based on the body mass index and 4.7% (7/146) were at the stage of advanced weight loss. According to immunovirological responses, 44.5% (65/146) were immunocompromised (CD4<500 cell/μl) and 75.3% (110/146) had an undetectable viremia (<40 copies/mL). CD4 count inversely correlated with total protein concentration (r = -0.18, p = 0.005**). Viremia was inversely correlated with albumin (r = -0.21; p = 0.047*), nutritional risk index (r = -0.28; p = 0.013*), total cholesterol (r = -0.27; p = 0.007**), and positively correlated with total protein (r = 0.27; p<0.001**) concentrations.

Conclusion: In this RLS, with patients having about five years of ART-experience, malnutrition appears to be driven mainly by a poor BMI, indicating that about one of ten patients falls within this severe condition. However, the largely normal nutritional profiles should be interpreted with caution, considering local realities and food support programs in place. The present outcomes highlight the need for monitoring nutritional status of people receiving ART in RLS, toward the design of optimal food interventions.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Correlation between LTCD4+ and total protein.
TP = Total protein; CI: Confidence Interval.
Fig 2
Fig 2. Correlation between viral load and albumin.
VL = viral load; CI: Confidence Interval.
Fig 3
Fig 3. Correlation between viral load and NRI.
VL = viral load; NRI = nutritional risk index; CI: Confidence Interval.
Fig 4
Fig 4. Correlation between viral load and total cholesterol.
VL = viral load; TC = total cholesterol; CI: Confidence Interval.
Fig 5
Fig 5. Correlation between viral load and total protein.
VL = viral load; TP = Total protein; CI: Confidence Interval.
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