Syndrome of depletion in HIV infection: diagnostic criteria and modern correction options

Abstract

The one of leading HIV infection manifestations is trophological insufficiency developing due to violation of digestion processes and leading to disease progress, development of multiple organ failure and lethal outcomes. The objective of research was to reveal the clinical and laboratory characteristics of patients with advanced stages of HIV infection and malnutrition, as well as the efficiency of nutritional support for this category of patients. Materials and methods. The study included 42 patients on the stage 4A-B HIV infection and underweight. All patients were on inpatient treatment in the department of palliative medicine of the St. Petersburg AIDS Center. Clinical-laboratory and instrumental measures were analyzed, the trophic status was estimated before the beginning of antiretroviral therapy (ART). The patients were divided in two groups. The first group received medical enteral nutrition (liquid mixture “Impact oral”). The second group received a regular balanced diet. At the same time, patients in both groups were prescribed ART in accordance with clinical guidelines. Results . A month after the start of treatment it was possible to analyze the results in the 1st group in 23 people and in 11 in the 2nd group. Comparative analysis showed that in the 1st group the distribution of the patients significantly changed according to the level of CD4 lymphocytes, BMI and nutritional status, with a markedly positive dynamics of these indicators. Also, patients of this group coped better with ART. Despite the fact that the analysis was conducted at the initial stages of the work, the obtained data demonstrate a high perspective of nutritional-metabolic therapy in the context of optimizing the HIV treatment in patients with a marked failure of the trophic status.