Malnutrition in hospitalized people living with HIV/AIDS: evidence from a cross-sectional study from Chengdu, China.
Hu Wen,Jiang Hua,Chen Wei,He Sheng-Hua,Deng Bin,Wang Wen-Yuan,Wang Yan,Lu Charles Damien,Klassen Karen,Zeng Jun
Asia Pacific journal of clinical nutrition
OBJECTIVES:Nutrition support has long been ignored in China's HIV/AIDS treatment and care. The objectives of this project were to evaluate the prevalence of malnutrition among Chengdu urban HIV positive patients, and to provide evidence for further nutritional intervention. MATERIALS AND METHODS:HIV-infected adults admitted to an infectious diseases inpatient unit were eligible for this study. Nutritional status was evaluated using Subject Global Assessment (SGA), Malnutrition Universal Screening Tool (MUST), body mass index (BMI), food frequency questionnaire and dietary records. RESULTS:94 hospitalized HIV positive patients were enrolled from April 2009 to May 2010. The median CD4 T cell count was 44.0/mm3. The prevalence of malnutrition is measured by three tools and ranged from 37.2% (by BMI) to 77.2% (by SGA class B/C or MUST scores ≥ 2). Chi-square test showed significant relationship between opportunistic infections and MUST score (OR=5.67, p<0.005, 95% CI=1.96-16.4). Of patients, 59.6% had insufficient total energy intake; while 54.3% had insufficient protein intake. CONCLUSIONS:Malnutrition is highly prevalent among Chengdu urban HIV/AIDS patients who underwent inpatient treatment. Calorie and protein deficiency should be given more attention in HIV/AIDS care programs. Nutrition evaluation and support should be considered an integral parts of national and community HIV/AIDS treatment and care guidelines.
Nutritional risk and nutritional status in hospitalized older adults living with HIV in Shenzhen, China: a cross-sectional study.
Liu Xiaoning,Cao Jing,Zhu Zheng,Zhao Xia,Zhou Jing,Deng Qiuxia,Zhang Liyuan,Wang Hui
BMC infectious diseases
BACKGROUND:Nutrition is a crucial factor that can impact morbidity and mortality in older people living with HIV (PLWH). Studies on nutritional risk and nutritional status in all age groups in PLWH have been conducted. However, few studies have focused on nutritional risk in older PLWH. This study aimed to describe the nutritional risk and nutritional status in older PLWH, and explore factors associated with nutritional risk and undernutrition status. METHODS:We conducted a cross-sectional study. We recruited participants aged 50 years or older from the Third People's Hospital of Shenzhen from January 2016 to May 2019. Nutritional risk and nutritional status were evaluated by the Nutritional Risk Screening 2002 (NRS 2002) tool, body mass index (BMI), albumin level, and prealbumin level on the first day of admission. Logistic regression models were used to identify the factors associated with undernutrition based on the BMI, albumin, and prealbumin criteria. RESULTS:A total of 196 older PLWH were included in the analysis. We found that 36% of hospitalized older PLWH had nutritional risk, and 12-56% of them had undernutrition based on the BMI, albumin, and prealbumin criteria. An increased nutritional risk score was associated with older age (β = 0.265 CI [0.021, 0.096], P = 0.002), a higher viral load (β = - 0.186 CI [- 0.620, - 0.037], P = 0.028), a lower BMI (β = - 0.287 CI [- 0.217, - 0.058], P = 0.001), and a lower albumin level (β = - 0.324 CI [- 8.896, - 1.230], P = 0.010). The CD4 count was associated with the prevalence of undernutrition based on the albumin criterion (OR = 15.637 CI [2.742, 89.178], P = 0.002). CONCLUSION:Our study indicated that nutritional screening, assessment, and management should be routinely performed in hospitalized older PLWH. HIV-specific measures should be used to assess nutritional risk, and albumin, BMI, and other assessments should be used in combination to identify undernutrition in older PLWH.
Nutritional screening tools for HIV-infected patients: implications for elderly patients.
Ruiz Marco,Kamerman Leigh Ann
Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)
BACKGROUND:Nutrition is a crucial issue for elderly HIV-infected patients. Screening tools (''DETERMINE your nutrition health checklist'' [NSI], the Mini-Nutritional Assessment [MNA], the Malnutrition Universal Screening Tool [MUST] test, and the modified version of the Subjective Global Assessment [SGA]-HIV) might not detect problems in visceral fat accumulation, visceral protein loss, and lipodystrophy in elderly HIV-positive populations. METHODS:Literature review of articles in English, French, and Spanish published in Medline and Cochrane databases through January 2010. RESULTS:New studies question the use of body mass index (BMI) and weight loss as proxies for nutritional problems in HIV-positive patients. In the case of elderly HIV-infected patients, screening tools to deal with the aforementioned issues are currently being investigated. CONCLUSION:The authors suggest that a unique nutritional screening test that contains measures including BMI, weight loss, waist-to-hip (W/H) ratio, and mid-arm circumference may be able to detect nutritional problems in elderly patients infected with HIV. Further trials combining these 4 anthropometric measures in elderly HIV-infected patients are needed.