Nutritional status of HIV/AIDS infected adults on HAART
| dc.contributor.author | Julsing, Claire Eanette | |
| dc.date.accessioned | 2015-11-24T08:47:28Z | |
| dc.date.available | 2015-11-24T08:47:28Z | |
| dc.date.issued | 2009-05 | |
| dc.description.abstract | English: The aim of this study was to describe the nutritional status of HIV/AIDS infected patients on two HAART regimens. A convenience sample of 111 HIV infected patients on HAART from the Helen Joseph CCMT site in Johannesburg were included (55% on regimen 1 and 45% on regimen 2). HAART regimens differed, with regimen 2 including protease inhibitor (PI) based therapy and regimen 1 a non-PI based therapy. Dietary intake, biochemical markers, lifestyle and anthropometric variables, as well as associations between the above were determined. Dietary intake was determined by means of a 24-hour recall of usual intake and a short food frequency questionnaire. Weight, height, body composition (using bioelectrical impedance), waist and hip circumference measurements were obtained to calculate body mass index (BMI) and fat distribution. Lifestyle factors included smoking habits, alcohol consumption and physical activity levels. These variables were determined by means of a questionnaire completed by the researcher in a structured interview with each participant. Adequacy of diet was evaluated by comparing each patient's dietary intake to the recommended servings of the Food Guide Pyramid. Approximately 70% of patients on HAART consumed less than the required amount of fruit servings per day. Low vegetable consumption was reported, and 98% (regimen 1) and 94% (regimen 2) of patients did not consume the recommended number of servings of vegetables per day. Refined carbohydrates were consumed by 96% of patients on regimen 1 and 84% of patients on regimen 2. Salt intake in this population group was high, with 93.44% of patients on regimen 1 and 94% of patients on regimen 2 consuming added salt every day. Polyunsaturated fats like sunflower oils and margarines were used daily by 92% of patients on regimen 1 and 80% of patients on regimen 2. Full cream dairy products were used more frequently than low fat dairy products, due to the cheaper price. Peanut butter, a monounsaturated fat, was consumed relatively frequently (66% on regimen 1 and 62% on regimen 2). Medians for carbohydrates, proteins, fat and total energy intake were 310g, 77g, 54g and 7968kJ per day for the 1st line regimen group. In the 2nd line regimen group the medians were as follows: carbohydrates 220.5g, protein 68g, fat 45g and total energy 9233kJ per day. Total energy intake and carbohydrate intake as a percentage of total energy were significantly higher in patients on regimen 1. Dietary intakes of participant in this study showed that the quality of the diet was poor and not conducive to optimal nutritional status. Anthropometric information included BMI, body composition analysis, waist circumference and waist hip ratio. Median BMI of patients in the 1nd regimen (25.34kg/m2) group were significantly higher that that of patients in the 1st regimen group (22.80kg/m2) when comparing medians for BMI. BMI was above 25kg/m2 in 32.79% and 56% of patients on regimen 1 and 2 respectively. Approximately half of all patients in this study had waist circumference measurements above the recommended 80cm for females and 94cm for males. Undesirable waist to hip ratio measurements (for females >0.8 and for males >0.9) occurred in 95% of patients on regimen 1 and 66% of patients on regimen 2. Central obesity, increased BMI and high risk waist circumference and waist to hip ratios were evident in the majority of patients. High body fat percentages (more than 25%) were present in more than half of all the patients in this study. No significant differences were apparent when comparing anthropometric medians between the two groups. A large percentage of patients in this study were at risk of developing chronic diseases according to the results of the anthropometric assessments. The incidence of dyslipidemia in this population was high, with almost half of patients (47.92%) on regimen 2 and 34.43% of patients on regimen 1 having elevated tryglyceride levels. HDL levels were low in 43.75% of patients on regimen 1 and 22.95% of patients on regimen 2. High cholesterol levels were prevalent in 39% of patients on regimen 1 and 27.66% of patients on regimen 2. Patients on regimen 1 had significantly higher median cholesterol levels than patients on regimen 2. LDL cholesterol levels were elevated in a 60.66% of patients on regimen 1 and 52.08% on regimen 2. Despite all patients being on HAART, low CD4 counts (<500) and high viral loads (≤25) were prevalent in the majority of participants. In regimen 1, 80.8% of patients had a CD4 count below 500 and viral load above 25, while patients on regimen 2, 78.0% showed similar results. The majority of patients reported never smoking, with only 18.03% of participants on regimen 1 and 14.00% on regimen 2 reporting current smoking. Reported alcohol consumption was relatively low with 21.31% of patients on regimen 1 and 24.00% of regimen 2 currently using alcohol. Eighty two percent of patients on regimen 1 and 93.88% of patients on regimen 2 were sedentary. The nutritional status of the HIV infected patients on HAART in this study was found to be poor. Anthropometric measurements, lifestyle factors and biochemical markers indicated that these patients had an increased risk for developing chronic disease. HIV/AIDS and HAART are linked with metabolic abnormalities and associated chronic diseases. Poor nutrition exacerbates the risk and urgent interventions are required in this population. | en_ZA |
| dc.description.abstract | Afrikaans: Die doel van hierdie studie was om die voedingstatus van MIV/VIGS pasiente op twee HAART regimes te beskryf. 'n Gerieflikheidsteekproef van 111 MIV geïnfekteerde pasiënte op HAART by die Helen Joseph CCMT kliniek in Johannesburg is ingesluit (55% op regime 1 en 45% op regime 2). HAART regimes verskil en regime 2 het 'n protease inhibitor (PI) ingesluit, terwyl regime 1 nie 'n PI ingesluit het nie. Dieetinname, biochemiese merkers, leefstyl veranderlikes en antropometriese inligting is ingesamel en verbande tussen veranderlikes is ook bepaal. Dieetinname is dmv 'n 24-uur herroep van gewoontelike inname en 'n kort voodselfrekwensievraelys bepaal. Massa, lengte, liggaamsamestelling (bepaal met bioimpedansie), middel en heupomtrek is gemeet om LMI en vetverspreiding te bepaal. Leefstylfaktore het rookgewoontes, alkholinname en fisiese aktiwiteit ingesluit. Hierdie veranderlikes is bepaal dmv 'n vraelys wat deur die navorser voltooi is in 'n gestruktureerde onderhoud met elke deelnemer. Die toereikendheid van die dieet is evalueer deur die inname van die hoeveelheid voedsels in die verskillende voedselgroepe te vergelyk met die aanbevole hoeveelheid ruile van die Voedselpiramiede. Ongeveer 70% van die pasiënte op beide HAART regimes het nie die aanbevole hoeveelheid vrugteruile per dag ingeneem nie. Lae groente inname is ook gerapporteer en 98% van pasiënte op regime 1 en 94% op regime 2 het nie die nodige hoeveelheid groente per dag ingeneem nie. Verfynde koolhidrate is deur 96% van die pasiënte op regime 1 en 84% op regime 2 ingeneem. Soutinname was hoog, met 93.44% van pasiënte op regime 1 en 94% op regime 2 wat daagliks bygevoegde sout geëet het. Polionversadigde vette, soos sonneblomolie en margarien, is daagliks deur 92% van pasiënte op regime 1 en 80% op regime 2 ingeneem. Volroom suiwelprodukte is meer algemeen as lae vet suiwelprodukte gebruik, waarskynlik agv die laer prys daarvan. Grondboontjiebotter, 'n mono-onversadigde vet, is relatief algemeen geëet (66% op regime 1 en 62% op regime 2). Mediaan inname van koolhidrate, proteïene, vet en energie was 310g, 77g, 54g en 7968kJ per dag onderskeidelik vir pasiënte op regime 1. In die tweede regime groep was die mediaaninname as volg: koolhidrate 221g, proteïen 68g, vet 45g en totale energie 9233kJ per dag. Totale energie inname en koolhidrate inname, as 'n gedeelte van totale energie was hoër in pasiënte op regime 1, hierdie resultaat was betekenisvol. Oor die algemeen was die dieetinname van pasiënte in hierdie studie van 'n swak gehalte en nie ideaal vir die bevordering van optimale voedingstatus nie. Antropometriese inligting het LMI, liggaamsamestelling, middelomtrek en middel heup verhouding ingesluit. Mediaan LMI van pasiënte op die tweede regime (25.34kg/m2) was betekenisvol hoër as die van pasiënte op die eerste regime (22.80kg/m2). LMI was bo 25kg/m2 in 32.79% en 56% van pasiënte op die eerste en tweede regime onderskeidelik. Ongeveer helfte van die pasiënte het middelomtrekke bo die aanbevole 80cm vir vroue en 94cm vir mans gehad. Hoë risiko middel heup verhoudings (vir vroue >0.8 en vir mans >0.9) het voorgekom in 95% van pasiënte op regime 1 en in 66% van pasiënte op regime 2. Sentrale vetsug, hoë LMI en hoë risiko middel-omtrek en middel heup verhoudings was sigbaar in meeste pasiënte. Hoë liggaamsvetpersentasies (meer as 25%) is in meer as die helfte van die pasiënte gesien. Antropometriese mediaan afmetings het gaan betekenisvolle verskille tussen die twee groepe aangetoon nie. Volgens die antropometriese inligting, het 'n groot persentasie van pasiënte in hierdie studie 'n risiko om lewenstylsiektes te ontwikkel gehad. Die voorkoms van dislipidemie in hierdie steekproef was hoog, met amper die helfte van die pasiënte op regime 2 (47.92%) en 34.43% van pasiënte op regime 1 wat hoë trigliseriedvlakke gehad het. HDL vlakke was laag in 43.75% van pasiënte op regime 1 en 22.95% op regime 2. Hoë cholesterolvlakke het voorgekom in 39% van pasiënte op regime 1 en 28% op regime 2. Mediaan cholesterolvlakke van pasiënte op die eerste regime (4.8mmol/l) was betekenisvol hoër as die van pasiënte op die tweede regime (4.4mmol/l). LDL cholesterolvlakke is verhoog in 61% van pasiënte op regime 1 en in 52% op regime 2. Ten spyte van die feit dat die pasiënte op HAART was, het lae CD4 tellings (,500) en hoë virale ladings (≤25) in die meerderheid van die pasiënte voorgekom. In regime 1 het 81% 'n CD4 telling onde r500 en 'n virale lading bo 25 gehad, terwyl 78% van die pasiënte op regime 2 dieselfde getoon het. Die meerderheid pasiënte het gerapporteer dat hulle nog nooit gerook het nie. Slegs 18% van die deelnemers op regime 1 en 14% op regime 2 het huidiglik gerook. Indien in ag geneem word dat pasiënte op HAART glad nie alkohol behoort te gebruik nie, is die persentasie wat wel alkohol gebruik het relatief hoog (21% op regime 1 n 24% op regime 2). Vlakke van fisiese aktiwiteit was laag (82% op regime 1 en 94% op regime 2 het baie lae vlakke van fisiese aktiwiteit gerapporteer). Die voedingstatus van MIV geïnfekteerde pasiënte op HAART in hierdie studie was oor die algemeen swak. Antropometriese metings, leefstylfaktore en biochemiese merkers het aangedui dat baie van die pasiënte 'n verhoogde risiko vir die ontwikkeling van leefstyl siektes gehad het. MIV/VIGS en HAART hou verband met metaboliese abnormaliteite en geassosieerde chroniese siekte. Swak voeding vererger die risiko en dringende voedingintervensies word vereis in hierdie populasie. | af |
| dc.identifier.uri | http://hdl.handle.net/11660/1815 | |
| dc.language.iso | en | en_ZA |
| dc.publisher | University of the Free State | en_ZA |
| dc.rights.holder | University of the Free State | en_ZA |
| dc.subject | Dissertation (M.Sc. (Dietetics))--University of the Free State, 2009 | en_ZA |
| dc.subject | AIDS (Disease) -- Nutritional aspects | en_ZA |
| dc.subject | HIV-positive persons -- Nutrition | en_ZA |
| dc.subject | Nutrition surveys | en_ZA |
| dc.subject | Dietetics | en_ZA |
| dc.title | Nutritional status of HIV/AIDS infected adults on HAART | en_ZA |
| dc.type | Dissertation | en_ZA |