Chronic energy deficiency and associated factors among adults living with HIV in Gondar University Referral Hospital northwest Ethiopia

Abstract

Background: Human Immunodeficiency Virus (HIV) infection and chronic energy deficiency are bidirectional and multifaceted. HIV can cause or worsen chronic energy deficiency by increasing energy requirements, reducing food intake and nutrient absorption. Chronic energy deficiency weakens the immune system, increase the susceptibility to infections and worsening the disease impact. Studies on the magnitude and factors associated with chronic energy deficiency among adults living with HIV are limited. The aim of this study was to assess the prevalence of chronic energy deficiency and associated factors among adults living with HIV in Gondar University Referral Hospital, northwest Ethiopia. Methods: An institution based cross-sectional study was conducted and systematic random sampling was used to select study subjects. A total of 317 study subjects were enrolled in the study. Structured and pretested questionnaire was used to collect socio-demographic, economic and diet related variables. Weight and height measurement were taken and medical charts were reviewed. Laboratory analysis for CD4 count and anemia was done. Bi-variable and multi-variable logistic regression analyses were used to assess the effect of different factors on chronic energy deficiency. Results: A total of 317 patients provide complete information with response rate of 99.4%. The overall prevalence of chronic energy deficiency was 18.3% (95%CI: 14.5%-22.7%). The prevalence of mild, moderate and severe chronic energy deficiency was 11.4, 3.5 and 3.5% respectively. No formal education (AOR = 2.05,95%CI:1.01,4.21), being in the WHO clinical stage three and four (AOR = 3.84,95%CI:1.39,10.61) and history of diarrhea in the last two weeks prior to the survey (AOR = 4.43,95%CI:1.83,10.72) were significantly associated with chronic energy deficiency. Conclusion: The prevalence of chronic energy deficiency among adults living with HIV was medium public health problem. Educational status, WHO clinical stage, and history of diarrhea in the last two weeks prior to the survey were risks for chronic energy deficiency. Integration of nutritional management with HAART, early diagnosis and treatment of diarrheal disease would be supreme important.