Abstract
Under nutrition and human immune deficiency virus/HIV have a vicious cycle. This study aimed to assess the pooled prevalence of under nutrition and determinants among adults receiving antiretroviral therapy in Ethiopia. Google scholar, PubMed, Cochrane library and web of science data bases were searched. Studies were assessed using risk of bias assessment tool. The heterogeneity of study was assessed using I2 test statistics. Data were pooled and a random effect meta-analysis model was fitted to provide the prevalence of under nutrition. Twenty-one studies that satisfy the eligibility criteria were included. The pooled prevalence of under nutrition among adults receiving ART was 27.4% (95% CI: 24.4-31.4). The pooled analysis showed that lack of RUTF was more likely to lead to under nutrition [AOR=2.34 (95%CI: 1.85- 3.85)]. Also under nutrition was more likely among adults receiving ART with WHO clinical stage four [AOR=2.01 (95%CI: 1.91- 3.82). The pooled prevalence of under nutrition was high and Lack of RUTF as well as WHO clinical stage 4 showed significant associations with under nutrition. This finding has implication to develop policy to improve under nutrition and to continue RUTF supplement program as an integral part of HIV/AIDS continuum of care.
Highlights
Under nutrition is a serious problem especially among Human Immune Deficiency Virus (HIV) positive clients receiving antiretroviral therapy
Findings from this systematic review showed that the pooled prevalence of under nutrition among adults on Antiretroviral Therapy was 27.4%
Under nutrition is more likely among clients who are at clinical stage 4 (OR: 2.01, 95%CI: 1.91, 3.82)
Summary
Under nutrition is a serious problem especially among HIV positive clients receiving antiretroviral therapy. Micronutrient deficiencies may increase viral load in the blood and affect immune functions. HIV infection in nutritionally deprived individuals intensifies the nutritional deficits and further enhances cellular oxidative stress. This affects the functions of transcription factors as NF-kB and contributes to HIV replication and progression and malnutrition could hasten the development of AIDS in an HIV-infected person [41]. Malnutrition and HIV form a vicious cycle and aim at reducing the immunity of the patient. In both malnutrition and HIV there is reduced CD4 and CD8 T-lymphocyte numbers [32].
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