Nutritional status of HIV-infected adults on antiretroviral therapy and the impact of nutritional supplementation in the Northern Cape Province, South Africa

Abstract

Objectives: The study aimed to describe the nutritional status and determine the impact of current nutrition intervention strategies on weight changes in adult HIV-infected patients on antiretroviral (ARV) therapy. Design: A descriptive, prospective trial was performed. Setting: The investigation was conducted at ARV roll-out centres in Kimberley, Upington, Kuruman, Prieska and Springbok in the Northern Cape Province of South Africa. Subjects: Adult HIV-infected patients receiving ARV therapy were included in the study. Outcome measures: Each participants’s body mass index (BMI) was determined before and after a four-month intervention period of nutritional supplementation with an instant, enriched maize product. Results: Data from 98 patients (mean age 39.7 years; standard deviation 8.9 years) were assessed. Prior to intervention, the median BMI was 20 kg/m2 (range 12.6–29.7 kg/m2); the patients from Kuruman had a greater incidence of underweight compared to the other towns, with a median BMI of 17.9 kg/m2. Of the 87 patients assessed during the final week, 49.4% experienced weight gain and 40.2% lost weight. Eighteen (20.7%) patients gained more than 5% of their baseline weight, which was significant. Only eight (9.2%) patients lost more than 5% of their baseline weight. Twenty-two patients who presented with a BMI < 18.5 kg/m2 at baseline had a median weight gain of 1.13 kg during the intervention period, while the group with a BMI > 18.5 kg/m2 presented with no change in median weight. Conclusions: Nutritional supplementation, provided according to provincial policy and combined with ARVs, nutritionally benefitted about half of the patients in the ARV programme in the Northern Cape.