scholarly journals Body Composition Changes Resulting from Nutrition Supplementation and Nutrition Education: Results from 2 × 2 Factorial Trial of 600 Rural Indian Women Living with HIV/AIDS

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 818-818
Author(s):  
Catherine Carpenter ◽  
Kavita Kapur ◽  
Padma Ramakrishna ◽  
Kartik Yadav ◽  
Maria Ekstrand ◽  
...  
Keyword(s):  
Body Composition ◽  
Nutrition Education ◽  
Muscle Mass ◽  
Women Living With Hiv ◽  
Nutrition Supplementation ◽  
Increased Risk ◽  
Factorial Trial ◽  
Cluster Randomized ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Objectives People living with HIV/AIDS are at increased risk of nutritional deficiencies. Loss of lean muscle mass has been associated with a more rapid decline of immune function and increased risk of mortality among individuals suffering from HIV. Our objectives were to evaluate the relative contributions of nutrition supplementation and nutrition education on body composition outcomes using a cluster randomized factorial trial among 600 women living with HIV/AIDS in rural Andhra Pradesh, India. Methods We conducted a prospective cluster randomized controlled 2 × 2 factorial design to assess impacts of nutritional education and nutritional supplementation over a six-month period, with follow up at six, twelve and eighteen months post enrollment. Study protocols were approved by Human Subjects Committees at the Universities of California at Los Angeles, Irvine, and San Francisco and the Ministry of Health in India. Interventions were delivered in the Nellore and Prakasam regions of Andhra Pradesh by trained lay village women, Ashas (Accredited Social Health Activists). Interventions included: usual supportive care provided by Ashas; 2) Asha Support plus Nutrition education; 3) Asha support plus Nutrition supplementation; and, 4) Asha support plus Nutrition education plus Nutrition supplementation. We measured body composition using a Bioimpedance Analyzer Model 310e. All data was analyzed using SAS 9.4. Results Mixed models evaluated change in lean muscle mass from baseline as the primary outcome, and fat weight, overall weight and BMI changes as secondary outcomes. Change in muscle mass from baseline was significantly associated with nutrition supplementation (P = 0.001), nutrition education (P = 0.01), with a significant interaction (P = 0.03) for the combined nutrition supplementation and education term. Using the same factorial structure, nutrition supplementation and education were independently associated with changes in BMI and fat mass. Conclusions Interventions that target nutrition may be an important approach to improving the physiologic response to HIV. We observed significant increases in muscle mass resulting from independent contributions of nutrition education and nutrition supplementation, as well as their combined contribution. Funding Sources NIMH R01MH098728.

scholarly journals Lean Mass Improvement from Nutrition Education and Protein Supplementation among Rural Indian Women Living with HIV/AIDS: Results from Cluster Randomized Factorial Trial at 18-Month Follow-Up

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 179
Author(s):  
Catherine L. Carpenter ◽  
Kavita Kapur ◽  
Padma Ramakrishna ◽  
Suresh Pamujula ◽  
Kartik Yadav ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Lean Mass ◽  
Andhra Pradesh ◽  
Protein Supplementation ◽  
Women Living With Hiv ◽  
Factorial Trial ◽  
Cluster Randomized ◽  
Living With Hiv ◽  
Hiv Aids

Loss of lean muscle mass impairs immunity and increases mortality risk among individuals with HIV/AIDS. We evaluated the relative contributions of protein supplementation and nutrition education on body composition among 600 women living with HIV/AIDS in rural Andhra Pradesh, India. We conducted a cluster randomized controlled 2 × 2 factorial trial lasting six months with follow up at twelve and eighteen months. Interventions occurred in the Nellore and Prakasam regions of Andhra Pradesh by trained village women, ASHA (Accredited Social Health Activists), and included: (1) the usual supportive care from ASHA (UC); (2) UC plus nutrition education (NE); (3) UC plus nutritional protein supplementation (NS); (4) combined UC plus NE plus NS. A Bioimpedance Analyzer Model 310e measured body composition. SAS 9.4 analyzed all data. Mixed models using repeated measures evaluated lean mass change from baseline as primary and fat weight and total weight as secondary outcomes. Lean mass change was significantly associated with NS (p = 0.0001), NE (p = 0.0001), and combined NS plus NE (p = 0.0001), with similar associations for secondary outcomes. Stronger associations for total weight were observed with greater ART adherence. Nutritional interventions may improve physiologic response to HIV. Significant increases in lean mass resulted from independent and combined protein supplementation and nutrition education.

Neuropsychological functioning in a cohort of HIV infected women: Importance of antiretroviral therapy

2002 ◽  
Vol 8 (6) ◽  
pp. 781-793 ◽  
Author(s):  
JEAN L. RICHARDSON ◽  
EILEEN M. MARTIN ◽  
NORA JIMENEZ ◽  
KATHLEEN DANLEY ◽  
MARDGE COHEN ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Test Performance ◽  
Neuropsychological Functioning ◽  
Women Living With Hiv ◽  
Hiv Positive Women ◽  
Increased Risk ◽  
Multi Center Study ◽  
Living With Hiv ◽  
Hiv Seropositive ◽  
Hiv Aids

We evaluated neurocognitive function in 149 HIV-seropositive and 82 seronegative women enrolled in the Women's Interagency HIV Study (WIHS), a large multi-center study of disease progression in women living with HIV/AIDS. We evaluated the prevalence of abnormal neuropsychological (NP) test findings in HIV-seropositive and seronegative women and factors associated with increased risk of abnormal NP test performance. Risk of NP impairment was no higher for HIV positive women receiving antiretroviral therapy at testing than for HIV-negative women (OR = 1.00). However, the risk of abnormal NP performance increased significantly for seropositive women not receiving antiretroviral therapy (OR = 2.43). Further, treatment status was a significant predictor of NP impairment in a multivariate analysis that included viral load (OR = 1.48) and CD4 count (OR = 1.08) which were not significant. The multivariate analyses controlled for substance use, age, education, head injury, ethnicity, estimated IQ, and psychological distress. This study emphasizes the critical association of antiretroviral therapy with the risk of neurocognitive impairment in women living with HIV/AIDS. (JINS, 2002, 8, 781–793.)

scholarly journals Increased chance of metabolic syndrome in women living with HIV/AIDS and lipodystrophic syndrome

2016 ◽  
Vol 49 (5) ◽  
pp. 421 ◽  
Author(s):  
Thiago Cândido Alves ◽  
Camila De Moraes ◽  
André Pereira dos Santos ◽  
Ana Cláudia Rossini Venturini ◽  
Rodrigo De Carvalho Santana ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Women Living With Hiv ◽  
Sindrome Metabolica ◽  
Terapia Antirretroviral ◽  
Living With Hiv ◽  
Total P ◽  
Lipodystrophic Syndrome ◽  
Hiv Aids

Modelo do estudo: Estudo de prevalência de corte transversal. Objetivo: comparar a sintomatologia critério para Síndrome Metabólica em homens e mulheres que vivem com HIV/aids, pacientes com Síndrome Lipoditrófica em terapia antirretroviral. Método: participaram do estudo 41 pacientes HIV positivos de ambos os sexos (18 a 69 anos), de um programa de orientação de exercício físico como terapia alternativa. Foi determinada a composição corporal total e regional por DXA, estatura, peso, circunferência de abdome, e determinação de parâmetros metabólicos (perfil lipídico e glicêmico) e imunológicos (detecção de carga viral e contagem de células T CD4+). Foram utilizados os critérios da IDF para o diagnóstico de SM. Resultados: As mulheres apresentaram maior gordura relativa (p = 0,001), obesidade central (p = 0,005), colesterol total (p = 0,043), LDL colesterol (p = 0,034) e contagem de CD4+ (p = 0,034) quando comparadas aos homens. Os valores médios para ambos os sexos apresentaram níveis elevados de triglicerídeos (> 211,4 mg.dL-1) e baixos de HDL (< 39,5 mg.dL- 1). A prevalência de Síndrome Metabólica nas mulheres foi duas vezes maior do que nos homens (p = 0,021), com significantes diferenças também na obesidade abdominal central (p = 0,005). Conclusões: A razão de prevalência (RP = 0,465) do sexo associado à Síndrome Metabólica indicou que as mulheres têm maior risco relativo e, portanto requerem ações alternativas na redução das chances de desenvolvimento desta síndrome

scholarly journals Outcomes of retained and disengaged pregnant women living with HIV in Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251413
Author(s):  
Agnes N. Kiragga ◽  
Ellon Twinomuhwezi ◽  
Grace Banturaki ◽  
Marion Achieng ◽  
Juliet Nampala ◽  
...  
Keyword(s):  
Post Partum ◽  
Urban Environments ◽  
Hiv Viral Load ◽  
Viral Loads ◽  
Women Living With Hiv ◽  
Resource Limited ◽  
Increased Risk ◽  
Exposed Infant ◽  
Public Clinics ◽  
Living With Hiv

Introduction Loss-to-follow-up among women living with HIV (WLWHIV) may lead to unfavorable outcomes for both mother and exposed infant. This study traced WLWHIV disengaged from care and their infants and compared their outcomes with those retained in care. Methods The study included WLWHIV who initiated ART during pregnancy at six public clinics in Uganda. A woman was defined as disengaged (DW) if she had not attended her 6-week post-partum visit by 10 weeks after her estimated date of delivery. DW were matched with retained women (RW) by age and duration on ART. Nurse counselors traced all selected DW via telephone and community visits to assess vital status, infant HIV sero-status and maternal HIV viral load through blood draws. Results Between July 2017 and July 2018, 734 women (359 DW and 375 RW) were identified for the study. Tracing was attempted on 349 DW and 160 (44.6%) were successfully located and enrolled in the study. They were matched with 162 RW. Among DW, 52 (32.5%) transferred to another health facility. Very few DW, 39.0% were HIV virally suppressed (<1000 copies/ml) compared to RW 89.5%, P<0.001). Among 138 babies born to DW, 4.3% tested positive for HIV compared to 1.4% among babies born to RW (P = 0.163). Conclusion Pregnant and breastfeeding WLWHIV who disengage from care are difficult to find in urban environments. Many have detectable viral loads, leading to the potential for an increased risk of MTCT. Efforts to reduce disengagement from care are critical for the successful elimination of MTCT in resource-limited settings.

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