Nutritional status of Malawian adults on antiretroviral therapy 1 year after supplementary feeding in the first 3 months of therapy.
OBJECTIVE
To test the hypothesis that individuals on antiretroviral therapy (ART) for 3 months with a greater body mass index (BMI) as a result of supplementary feeding with ready-to-use fortified spread would maintain a higher BMI 9 months after the feeding ended.


METHODS
Two cohorts of wasted adults with AIDS, after 12 months of ART and 3 months of supplementary feeding with either ready-to-use fortified spread, an energy dense lipid paste; or corn/soy blended flour, were assessed for clinical and anthropometric status, quality of life, and ART adherence after 3 and 9 months.


RESULTS
336 ART patients participated: 162 who had received ready-to-use fortified spread and 174 who had received corn/soy blended flour. 9 months after stopping food supplements, both groups had a similar BMI, fat-free body mass, hospitalization rate and mortality. Binary logistic regression modelling showed that lower BMI, lower CD4 count, and older age at baseline were associated with a higher risk of death (odds ratio for BMI = 0.63, 95% CI 0.47-0.79). Adherence to the ART regimen and quality of life were similar in both cohorts.


CONCLUSIONS
While supplementary feeding with ready-to-use fortified spread can ameliorate the BMI, an established risk factor for mortality, this effect is sustained only during the time of the intervention. Supplementary feeding of wasted patients for longer than 3 months should be investigated.
Ndekha
Macdonald
M
Department of Community Health, College of Medicine, University of Malawi, Blantyre, Malawi.
van Oosterhout
Joep J G
JJ
Saloojee
Haroon
H
Pettifor
John
J
Manary
Mark
M
D000328:Adult; D044966:Anti-Retroviral Agents / Q000009:adverse effects*; D015992:Body Mass Index; D019587:Dietary Supplements; D004812:Epidemiologic Methods; D005260:Female; D005527:Food, Fortified; D019247:HIV Wasting Syndrome / Q000178:diet therapy* / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D008297:Male; D011788:Quality of Life; D013997:Time Factors
D044966:Anti-Retroviral Agents