The impact of nutrition on CD4+ levels for HIV-positive Kenyan adults

Abstract

Background: HIV infection is highly prevalent in sub-Saharan Africa. Many people living with HIV infection in the region are malnourished or food insecure, which may affect HIV outcomes such as CD4+ levels. Study purpose and design: We conducted a cross-sectional study of ambulatory HIV-positive adult patients who lived in the vicinity of Kijabe, Kenya, a rural town served by the Kijabe Hospital outpatient clinic and 3 satellite clinics. All patients had received highly active antiretroviral therapy for at least 6 months. The purpose of the study was to determine the daily caloric and protein intake among these patients and their effects on CD4+ levels. Methods: All patients who consented to participate in the study completed dietary recall surveys to record their food and beverage intake for the previous 3 days. The medical records of the participants were reviewed to confirm that the respondents met the study inclusion criteria. Participant intake was compared to the recommended daily intake of calories and protein using predictive equations. Bivariate correlation was used to analyze the relationship between the CD4+ level and meeting the recommended daily caloric and protein intake. Results: Among the 122 participants who were eligible for the study, caloric and protein recommended intake, respectively, averaged 68.8% and 102.9% in males and 74.4% and 102.9% in females. There was a statistically significant positive correlation between protein consumption and CD4+ levels for males but not for females. Conclusion: The study results suggest that predictive equations currently in use underestimate protein recommendations for HIV-positive males. Further investigation is needed to re-evaluate current predictive equations and nutrient requirements in HIV-infected individuals. Research in these areas will likely benefit HIV outcomes as well as raise awareness of the importance to maximize local resources for food security. © 2013 Vaughan EM, et al.