16th International AIDS Conference


Toronto, Canada - August 13 - 18, 2006

A PILOT RANDOMIZED TRIAL OF NUTRITIONAL SUPPLEMENTATION IN FOOD INSECURE PATIENTS RECEIVING ANTIRETROVIRAL THERAPY (ART) IN ZAMBIA

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. MoAb0401

Megazzini K.1, Washington S.1, Sinkala M.2, Lawson-Marriott S.3, Stringer E.1, Krebs D.1, Levy J.1, Chi B.1, Cantrell R.1, Zulu I.4, Mulenga L.1, Stringer J.1
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

BACKGROUND: In many parts of sub-Saharan Africa, where the need for ART is most urgent, there is also widespread hunger. Whether food supplementation can improve clinical and adherence outcomes of food insecure populations on ART has been widely debated, but not yet tested.

METHODS: In the context of a home-based adherence support program attached to 8 government clinics in Lusaka, we randomly assigned 4 clinics to provide a monthly household food ration (micronutrient-fortified corn-soya blend, from World Food Programme) to food insecure patients starting ART; 4 clinics served as controls. Weight and CD4+ change were measured at 6 and 12 months. Adherence was assessed by timeliness of pharmacy visits.

RESULTS: At baseline, the median age, BMI, CD4+ count, WHO stage, hemoglobin, or gender distribution did not differ significantly between 375 food recipients versus 161 non-recipients. For those receiving food, median number of rations received was 9 (IQR: 6-10); median time between starting ART and first ration was 70 days (IQR: 44-125). We observed negligible differences in weight gain (kg) at 6 months (+5.6 vs. +5.0; p=0.48) and 12 months (+6.2 vs. +5.5; p=0.44) between food recipients and non-recipients. However, food recipients had a substantially greater increase in CD4+ count at 12 months than did non-recipients (+185 vs. +113; p=0.017). The mean number of days late for pharmacy visits per month was lower among food recipients versus non-recipients (2.4 vs. 3.4; p=0.008). Both the CD4+ and adherence findings remained statistically significant in multivariate analyses adjusting for sex, WHO Stage, and BMI at entry.

CONCLUSIONS: In this pilot study, a monthly household food ration for food insecure patients commencing ART improved adherence by 40% and resulted in a better CD4+ response at 12 months of therapy. Further study is warranted of food supplementation as an adjunct to ART in food insecure patients.

Acrobat ReaderDownload PDF of this abstract.

Power Point PresentationDownload Power Point Presentation.

2006-08-13
MoAb0401

Copyright © 2006 - International AIDS Society (IAS). All information and content relating to the abstracts from the 16th International AIDS Conference, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is a 501c(3) not-for-profit organization made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, GlaxoSmithKline, the National Library of Medicine, Roche / Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.