THE IMPACT OF NUTRITIONAL STATUS AND HIV DISEASE PROGRESSION ON SURVIVAL IN PATIENTS WITH HIV INFECTION (IMMUNE DEFICIENCY, DISEASE PROGRESSION).

Description

Acquired immunodeficiency syndrome (AIDS) has been identified as the number one public health priority in the United States. A prominent clinical feature of AIDS is progressive weight loss often referred to as the "wasting syndrome". HIV infection and AIDS are highly associated with poor survival, as with severe protein calorie malnutrition. While great strides have been made in understanding the HIV virus and the therapeutic management of AIDS, limited work has been published on the evaluation and treatment of AIDS-associated malnutrition and its impact on survival. The purpose of this study was to investigate the predictive effect of CD4 count and percent, and nutritional status, as measured by body weight and serum albumin on survival in patients with HIV infection. The results of this study demonstrated that as CD4 count and CD4 percent fall, nutritional status deteriorates and the number of deaths increase. In the analysis between all survivors and nonsurvivors, those who died were more advanced in HIV disease, were older and had a poorer nutritional status. In those patients with the most advanced disease, the differences between those who survived and those who did not were their age and nutritional status. In an attempt to predict relative risk of death, all variables were significant predictors by themselves and when placed in multivariate models, CD4 markers, age and percent usual body weight were always significant, whereas serum albumin was sometimes predictive. In conclusion, this study demonstrates that the nutritional status of persons with HIV infection predicts their survival, even after adjusting for age and CD4 counts. To optimally prevent and treat HIV-associated malnutrition, more studies are needed to elucidate its incidence, prevalence, etiologies and clinical course.

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