AIDS 2006 - Nutrition and HIV

Nutrition and HIV

MOAB04

Type:

Oral abstract session

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Venue:

Session Room 5

Interpretation:

None

Time:

16:15 - 17:45

Code:

MOAB04

Co-Chairs:

Subhasree Raghavan, India
Nigel Rollins, South Africa

Presentations in this session:
16:15
MOAB0401
Abstract
Powerpoint (1.25 MB) A pilot randomized trial of nutritional supplementation in food insecure patients receiving antiretroviral therapy (ART) in Zambia
Presented by Karen Megazzini, Zambia
K. Megazzini¹, S. Washington¹, M. Sinkala², S. Lawson-Marriott³, E. Stringer¹, D. Krebs¹, J. Levy¹, B. Chi¹, R. Cantrell¹, I. Zulu⁴, L. Mulenga¹, J. Stringer¹
¹Centre for Infectious Disease Research in Zambia, Lusaka, Zambia, ²Lusaka Urban District Health Management Team, Lusaka, Zambia, ³World Food Programme, Lusaka, Zambia, ⁴University Teaching Hospital, Medicine, Lusaka, Zambia

16:30
MOAB0402
Abstract
Powerpoint (554 KB) Micronutrient supplementation increases CD4 count in HIV-infected individuals on HAART: a prospective, double-blinded, placebo-controlled trial
Presented by Jon Kaiser, United States
J. Kaiser¹, M. Baum², A. Campa², J. Ondercin³, G. Leoung⁴, R. Pless⁵
¹University of California at San Francisco Medical School, Medicine, San Francisco, United States, ²Florida International University, Nutrition, Miami, United States, ³The Jonathan Lax Treatment Center, Philadelphia, United States, ⁴Saint Francis Memorial Hospital, HIV Care, San Francisco, United States, ⁵Ovation Research Group, Highland Park, United States

16:45
MOAB0403
Abstract The role of selenium as adjunct to haart among HIV infected individuals who are advanced in their disease
Presented by Nkiruka Nonyelum Odunukwe, Nigeria
N.N. Odunukwe¹, D. Onwujekwe¹, O.O. Ezechi¹, P. Ezobi¹, T. Gbajabiamila¹, R. Anyanwu¹, E. Iloka¹, R. Adu¹, O. Nwogbe¹, R. Audu¹, E. Herbertson¹, E.O. Idigbe¹, P. Kanki²
¹Nigerian Institute of Medical Research, Clinical Science Division, Yaba, Nigeria, ²Harvard School of Public Health, Boston, United States

17:00
MOAB0404
Abstract
Powerpoint (370 KB) Growth and body composition in children beginning or changing antiretroviral therapy
Presented by Caroline Chantry
C. Chantry¹, M. Hughes², C. Alvero², J. Cervia³, J. Hodge⁴, P. Borum⁵, J. Moye⁶, PACTG 1010
¹University of California Davis Medical Center, Pediatrics, Sacramento, California, United States, ²Harvard School of Public Health, Center for Biostatistics in AIDS Research, Boston, Mass, United States, ³Albert Einstein College of Medicine, Clinical Medicine and Pediatrics, East Hills, New York, United States, ⁴Frontier Science & Technology Research Foundation, Amherst, New York, United States, ⁵University of Florida, Food Science and Human Nutrition, Gainesville, Fla, United States, ⁶NIH, NICHD, Bethesda, Maryland, United States

17:15
MOAB0405
Abstract
Powerpoint (559 KB) Impact of HIV status on patterns of mortality in HIV infected severely malnourished children, admitted to 3 nutrition rehabilitation units in the central region of Malawi
Presented by Jobiba Chinkhumba, Malawi
J. Chinkhumba¹, P. Fergusson², S. Thurstans³, G. Nyirenda¹, H. Mafupa¹, A. Tomkins⁴
¹Action Against Hunger, HIV research, Lilongwe, Malawi, ²Action Against Hunger, University of Chester, HIV and nutrition, Chester, United Kingdom, ³Action Against Hunger, HIV and nutrition, Lilongwe, Malawi, ⁴Institute of Child Health, London, United Kingdom

Audio files:

English audio file (mp3 format, 43.2 MB)

Rapporteur report

Science Track B: Clinical Research, Treatment and Care report by Dr Claire Thorne

Nutritional support may augment treatment outcomes, but further well-designed studies on nutritional support in HIV-infected patients, including immunological and clinical response, and dietary intake data are needed to better inform future policy decisions.

Two randomized trials on macro and micro-nutrient supplementation in adults were reported, and two paediatric studies – one on growth and body composition in relation to starting or changing ART and the other on the association between severe malnutrition, HIV status and mortality.

Megazzini and colleagues reported on a pilot study in which adults on HAART were randomized to receive food support or not. Subjects receiving food support gained more weight and had increased CD4 counts, possibly on account of better adherence to HAART. Kaiser reported on a small trial in which 40 adults on HAART were randomized to receive a broad range of micronutrients and three specific antioxidants or placebo. CD4 counts measured after three months were higher in the supplemented group but there were no changes in viral load. The discussion raised several concerns about the small sample size, study design and lack of clinical correlates and concluded that this study would not justify any change in current recommendations. Odunukwe and co-workers reported on a non-randomized study from Nigeria in which adults on HAART were allocated to receive 200ug selenium daily or not, with results at 72 weeks suggesting improved survival and fewer OIs in the supplemented group. .

Chantry presented data from PACTG 1010, which compared growth and body composition of children starting on HAART or changing onto a PI regime against NHANES reference values and exposed, uninfected children from the WITS. Children on HAART gained lean body mass compared to reference values and had comparatively greater gains in linear growth suggesting altered growth hormone sensitivity independent of changes in viral load.

An audit of mortality outcomes in HIV-infected and uninfected severely malnourished children in Malawi, where children received standard of care treatment for severe malnutrition, showed that case fatality rates in HIV-infected children were 3.45 times greater than in uninfected children. However, HIV-related wasting could not be distinguished from severe malnutrition due to food insufficiency.

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