Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.
High-energy, high-protein, oral, liquid, nutrition supplementation in patients with HIV infection: effect on weight status in relation to incidence of secondary infection.
J Am Diet Assoc. 1996 Apr;96(4):337-41. Unique Identifier : AIDSLINE MED/96181022 Stack JA; Bell SJ; Burke PA; Forse RA; Surgical Metabolism Laboratory, Deaconess Hospital, Cancer; Research Institute, Boston, MA,02215, USA.
Abstract:
OBJECTIVE: to evaluate the use of high-energy, high-protein, oral, liquid, nutrition supplementation and nutrition counseling on the weight status of patients infected with the human immunodeficiency virus (HIV) with and without secondary infections. DESIGN: Prospective, descriptive, intervention trial. Follow-up clinic visits were scheduled every 1 to 3 weeks for at least 6 weeks to monitor weight, gastrointestinal symptoms, number of supplements consumed, and incidence of secondary infections. SUBJECTS/SETTING: Community-based, HIV-infected patients, with and without an acquired immunodeficiency syndrome (AIDS) defining illness, who were receiving outpatient medical care at Deaconess Hospital. Twenty-two patients enrolled; however, 4 dropped out and 1 died, so 17 were eligible for evaluation. INTERVENTION: Dietary counseling consisted of recommendations to consume a high-protein diet (1.5 g/kg ideal body weight); select foods that minimize gastrointestinal complications; and take at least one high-energy, high-protein, oral, liquid, nutrition supplement daily. MAIN OUTCOME MEASURES: Energy intake from the supplements and weight change over time in relation to whether a secondary infection occurred. STATISTICAL ANALYSIS: Means, standard deviations, and frequency. RESULTS: At the time of entry to the study, the patients with preexisting weight loss (16 of 17) were 14+/-8% below their usual body weight. On average, patients consumed 11+/-4 supplements per week for 6+/-3 weeks. The majority (12 of 17) were able to gain or maintain weight. Overall weight change was 1.1+/-2.2 kg. Only 5 of 17 patients lost weight, 4 of whom developed a secondary infection during the study (ie, after enrollment in the study). All of those who developed a secondary infection were classified as having AIDS and had lower mean CD4 counts at baseline than those who did not develop a secondary infection. Although those who developed a secondary infection had a higher incidence of weight loss, their consumption of oral supplements per week was greater than that of those without a secondary infection. APPLICATIONS/CONCLUSIONS: In patients with HIV infection and in the early stages of AIDS without a secondary infection, weight gain and/or maintenance was achievable with a high-energy, high-protein, oral, liquid, nutrition supplement in conjunction with nutrition counseling. The majority of the patients who developed a secondary infection, however, lost weight despite the use of supplements and counseling. Use of a high-energy, high-protein, oral, liquid, nutrition supplement, with intact nutrients, should be the first-line nutrition treatment for malnourished, HIV-infected patients without secondary infections.
Keywords: Adult AIDS-Related Opportunistic Infections/*EPIDEMIOLOGY *Body Weight Caloric Intake Dietary Proteins/ADMINISTRATION & DOSAGE Dietary Services Follow-Up Studies *Food, Fortified Human HIV Infections/COMPLICATIONS/*DIET THERAPY Incidence Intervention Studies Male Middle Age Nutrition Disorders/ETIOLOGY/PREVENTION & CONTROL Prospective Studies Support, Non-U.S. Gov't CLINICAL TRIAL JOURNAL ARTICLE
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Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.
