NURITIONAL STATUS OF PEOPLE LIVING WITH HIV/AIDS ATTENDING CLINICS IN NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI, ANAMBRA STATE. SOUTHEAST NIGERIA

Ogbu, I.S.I, Ugwu, M.C, Ukibe, N.R, Mbachu, N.A, Ogbu, C.C, Nwobodo, E.I

ABSTRACT

Malnutrition leads to immune impairment, worsens HIV infection and can contribute to more rapid progression to AIDS. This study assessed the nutritional status of people living with HIV/AIDS (PLWHA) attending Nnamdi Azikiwe University Teaching Hospital Nnewi in Anambra State, Southeast Nigeria. Fifty (50) PLWHA (twenty five [25] drug naïve and twenty five [25] on treatment) were recruited for the study. Clinical status of the subjects were obtained from the hospital records. A questionnaire and Subjective Global Assessment form were used to obtain nutritional status of the subjects. Serum total protein, albumin and haemoglobin were assayed spectrophotometrically while iron, copper, zinc and selenium were assayed using AAS. CD4+ count of the patients was done by flow cytometer. The results showed that body mass index, BMI (19.20±2.04kg/m2), mid upper arm circumference, (MUAC) 1.88m2 ±0.14 m, CD4+ count (309±140), albumin (2.30±0.27g/dl), Hb (11.92±1.10g/dl), serum iron (0.54±0.0.05ppm), zinc (0.58±0.09ppm) and selenium (0.57±0.06ppm) of drug naïve patients were significantly lower than those of on-treatment group; BMI-22.74±2.59kg/m2, CD4+ count 486± 119, albumin 2.68±0.27g/dl, Hb 12.82±1.12g/dl, serum iron 0.63±0.08ppm, zinc 0.75±0.11ppm, and selenium 0.72±0.09ppm and control group; BMI -22.74±2.59kg/m2, albumin – 3.44±0.36g/dl, Hb – 13.58±0.21g/dl, iron -18±0.14ppm, zinc - 1.18±0.15ppm, selenium - 1.06±0.14ppm, (p = 0.00). The parameters of the on-treatment group; BMI- (22.74±2.59kg/m2), CD4+ count (486±119), albumin (2.68±0.27g/dl), Hb (12.82±1.12g/dl), serum iron (0.63±0.08ppm), zinc (0.75±0.11ppm) and selenium (0.72±0.09ppm) as well as mid upper arm circumference (2.11±0.35m) were also significantly lower than those of the control group (p = 0.00). However, serum total protein (9.63±1.71g/dl), and copper (1.35±0.17ppm) of the drug naïve patients were significantly higher than those of the on-treatment (8.48±1.93g/dl, 0.81±0.12ppm) and control groups (7.05±0.84g/dl, 0.77±0.09ppm), (p = 0.00) while those of the on-treatment group were also higher than the control (p – 0.00).Subjective Global Assessment index showed that 56% and 40% respectively of the drug naïve and on-treatment HIV/AIDS patients were undernourished. PLWHA studied were undernourished and this can hinder effective management. Abnormal trace element levels seems to be basically due to the presence of the HIV in the host and might not be corrected by drug treatment alone. Adequate nutrition deserves even greater attention in the management of PLWHA especially in economically poor setting.

Keywords: “Nutrition”, “nutritional status”, “malnutrition”, “HIV/AIDS”, “trace elements”.