Oral supplements in HIV-infected patients with chronic wasting. A prospective trial.
OBJECTIVE
Supplementation with polymeric formula diet was evaluated as second step of a nutritional intervention program for malnourished, but otherwise clinically stable HIV-infected patients.


METHODS
34 patients with weight loss, without opportunistic infections, diarrhea or fever, not responding to nutritional counselling as first intervention, were included. They were given 1000 kcal per day as polymeric formula. If further weight loss occurred, dose was increased to 1500 kcal per day. Nutritional status was determined by body weight and bioelectrical impedance.


RESULTS
After four weeks, 7/34 patients already stopped intake. Only 10/34 patients completed three months of treatment. The average intake during three months was 496 +/- 363 kcal/d. Reasons for drop-out were intervening clinical deterioration in eight, early improvement in six, but intolerance or loss to follow-up in ten patients. On average, body weight did not change. Intake of formula diet and weight changes were not correlated.


CONCLUSIONS
Oral supplements are a feasible, cost-effective and safe treatment of malnutrition, but they are accepted only for short time and in limited amount. To estimate efficacy of this treatment, clinical reasons for malnutrition must be considered. More effective nutritional treatments are needed for chronically malnourished HIV infected patients.
Bürger
B
B
Department of Internal Medicine, University of Cologne, Germany.
Schwenk
A
A
Jünger
H
H
Ollenschläger
G
G
Wessel
D
D
Diehl
V
V
Schrappe
M
M
D000328:Adult; D001835:Body Weight; D002149:Energy Intake; D005527:Food, Fortified; D015658:HIV Infections / Q000178:diet therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010349:Patient Compliance; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000178:diet therapy*