Nutritional and immunological status and their associations among HIV-infected adults in Addis Ababa, Ethiopia.
BACKGROUND
In the search for cost-effective interventions to reduce morbidity and mortality in HIV disease, the identification of nutritional status and levels of micronutrients is very important.


OBJECTIVE
To generate information on the level of energy malnutrition and on vitamin A, zinc, and hemoglobin levels and their relationships with disease status in HIV-infected adults in Addis Ababa, Ethiopia.


METHODS
A cross-sectional study was carried out on 153 HIV-positive adults (19% male, 81%female) living in Addis Ababa. The nutritional status and the levels of zinc, retinol, and hemoglobin were determined by anthropometric and biochemical methods. CD4+ counts and C-reactive protein levels were measured by standard methods.


RESULTS
Of the patients, 18% were chronically energy deficient, 71% were normal, and 11% were overweight. Serum zinc levels were low (< 10.7 micromol/L) in 53% of subjects, and serum retinol levels were low (< 30 microg/dL) in 47% of subjects. Low hemoglobin levels (< 12 g/dL) were observed in only 4.72% of the study population. CD4+ counts under 200/mm3 and elevated C-reactive protein levels were both found in 21% of the subjects. CD4+ counts were positively and significantly correlated with hemoglobin (r = 0.271, p < .001), zinc (r = 0.180, p < .033), and body mass index (r = 0.194, p < .017). There were significant negative associations between levels of C-reactive protein and levels of zinc (r = -0.178, p < 0.036 and hemoglobin (r = -0.253, p < .002).


CONCLUSIONS
Our results provide evidence that compromised nutritional and micronutrient status begins early in the course of HIV-1 infection. Low serum zinc and vitamin A levels were observed in almost half of the subjects. The clinical significance of low serum zinc and vitamin A levels is unclear, and more research is required.
Fufa
Habtamu
H
Ethiopian Health and Nutrition Research Institute (EHNRI), Addis Ababa, Ethiopia. hfufa@yahoo.com
Umeta
Melaku
M
Taffesse
Samson
S
Mokhtar
Najat
N
Aguenaou
Hassan
H
D000328:Adult; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005002:Ethiopia; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000276:immunology*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D008875:Middle Aged; D009752:Nutritional Status; D012720:Severity of Illness Index; D014801:Vitamin A / Q000097:blood; D014802:Vitamin A Deficiency / Q000453:epidemiology*; D055815:Young Adult; D015032:Zinc / Q000097:blood / Q000172:deficiency*
D006454:Hemoglobins; D014801:Vitamin A; D002097:C-Reactive Protein; D015032:Zinc