Abstract
BackgroundThe average lifespan of people with human immunodeficiency virus (HIV) has increased because of the enhanced access to anti-retroviral treatment. This increased longevity has led to a heightened focus on the comorbidities which may arise, allowing a clearer understanding of the contextual, personal, psychological and functional problems and their interrelations. Disability (functional limitations) and insufficient nutritional intake may interact cyclically with HIV and/or acquired immunodeficiency syndrome (AIDS); however, no research to date has investigated this interaction.AimsThe objective of this article was to report on the nutritional outcomes using albumin and body mass index outcomes as a subset of a larger study among adults living with HIV and/or AIDS.SettingThis study was conducted at a large HIV clinic based in an urban area in Johannesburg, South Africa, which provides HIV treatment and support to over 6000 persons with HIV and TB. This clinic is part of a large public health regional hospital where extensive HIV research is undertaken.MethodsThis study was a cross-sectional observational study. The sample composed of 278 participants between 18 and 65 years of age and had been on highly active antiretroviral therapy (HAART) for more than six months. Statistical analyses were performed using the Statistical Package for the Social Sciences.ResultsThe results indicated that albumin level had significant inverse associations with functional limitations and physical health symptoms. Women were significantly more likely to have lower nutritional levels. A logistic regression analysis suggested that gender and physical health symptoms were the primary predictors of albumin levels.ConclusionThe findings presented in this article can be applied to HIV and/or AIDS treatment programmes, such as HAART. It re-emphasises the importance of providing individuals on anti-retroviral therapy with affordable and adequate nutrition, education on the importance of nutritional intake and the benefits of potentially adopting supplement programmes. As females seem to be more adversely affected by low nutritional levels, with the findings showing an increased likelihood of developing physical health symptoms, focus also needs to be given to cultural or social factors that impact nutritional intake in women.
Highlights
The level of impact that the human immunodeficiency virus and/or acquired immunodeficiency syndrome (HIV and/or AIDS) has on people’s lives and on community development is overwhelming.[1,2,3] HIV remains one of the greatest public health concerns contributing to mortality and, increasingly, morbidity in the Southern African region.[4,5] The disease and its social impact can have devastating effects on livelihoods.[6,7] Anti-retroviral therapy (ARV) slows down the progression of the virus but does not eliminate it
The level of nutrition as measured by albumin in this subgroup was 41.17 g/L, while those who had measures of 40 and below had a mean of 36.31 g/L (SD = 3.95) and those above 40 had a mean of 44.27 g/L (SD = 2.42). This is comparable with the results reported by Stambullian et al.[52] who reported a mean of 45 g/L for both patients living with AIDS and who are HIV positive, but these results are different from the findings of Santos and Almeida[40] who found that malnourished individuals had an albumin level of 28.1 g/L
This article focuses on investigating the interaction between nutritional levels and functional limitations and/ or disability in a cohort of people on long-term anti-retroviral therapy (ART)
Summary
The level of impact that the human immunodeficiency virus and/or acquired immunodeficiency syndrome (HIV and/or AIDS) has on people’s lives and on community development is overwhelming.[1,2,3] HIV remains one of the greatest public health concerns contributing to mortality and, increasingly, morbidity in the Southern African region.[4,5] The disease and its social impact can have devastating effects on livelihoods.[6,7] Anti-retroviral therapy (ARV) slows down the progression of the virus but does not eliminate it. The average lifespan of people with human immunodeficiency virus (HIV) has increased because of the enhanced access to anti-retroviral treatment. This increased longevity has led to a heightened focus on the comorbidities which may arise, allowing a clearer understanding of the contextual, personal, psychological and functional problems and their interrelations. Disability (functional limitations) and insufficient nutritional intake may interact cyclically with HIV and/or acquired immunodeficiency syndrome (AIDS); no research to date has investigated this interaction
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