A baseline studies on the nutritional interplay between HIV drugs and kidney, liver and heart indices in patients receiving HIV treatment in North-Central Nigeria

Abstract

Malnutrition is one of the major problems among those infected with HIV/AIDS receiving Antiretroviral Therapy (ART). Various studies have shown that HIV infection and malnutrition are intricately linked to each other. In the absence of proper nutrition and treatment, HIV infection can lead to malnutrition which in turn impairs the immune system there by progressing HIV to AIDS, conversely use of ART has been reported to have significant effect on people living with HIV. This study aims at assessing the nutritional interplay between HIV drugs and kidney, liver, and heart indices among subjects undergoing HIV treatment at medical out-patient department of Federal Medical Centers in North Central part of Nigeria. A hospital based cross-sectional study was conducted where 677 people living with HIV attending the ART clinic were selected using a systematic random sampling technique. Nutritional status among these people was assessed through anthropometry Body Mass Index (BMI) and were classified accordingly; Underweight (BMI < 18.5 kg/m2) and overweight/obesity (BMI > 23 kg/m2). Patients information’s including HIV associated risk factors, opportunistic infections, ART regimen, etc. were collected from the medical record department. Socio-demographic data were collected using structured questionnaire. Blood samples were collected to access kidney, liver and heart indices as well as levels of Vitamin D and trace elements such as Zinc and Selenium. Chi-square was used to test for a significant difference between sociodemographic characteristics and BMI, while ANOVA was used to compare the levels of kidney, liver and heart indices as well as vitamin D, Zn and Se based on BMI status at 95% C.I. Most of the study participants were overweight 201 (29.7%) and obese 211 (31.2%), a large number had a normal BMI 32.9%. The prevalence of underweight was found to be 42(6.2%). there was a significant increase in the level of some kidney, liver and cardiac indices in participants who were overweight and obese compared to those who were normal and underweights, these significant increase was observed in the levels of Na, K, Cl, HCo3, ALP, AST, ALT, Cholesterol, LDL and TG. There was a significant decrease in levels of Vitamin D, Zn and Se in participants who were underweight. Underweight, overweight and obesity are emerging problem among HIV patients on ART. Patients undergoing ART should be placed under strict nutritional monitoring and be subjected to nutritional supplementation to avert untimely death, also effort should be made to address the burden of malnutrition by addressing identified determinants.