Role of intestinal dysfunction in the nutritional compromise seen in human immunodeficiency virus-infected adults in rural India
Research snapshot1
The study was carried out in 2006 in Tamil Nadu. The target population is mainly agrarian, with many being subsistence farmers and labourers. A cross-sectional survey was conducted among 45 consenting HIV-infected, antiretroviral therapy (ART) naive participants attending an HIV clinic and 45 age and socioeconomic matched HIV-negative, neighbourhood population controls. The extent of intestinal dysfunction was assessed using a D-xylose absorption test and association with nutritional compromise was measured by body mass index (BMI) and serum antioxidant levels.
Results found that a similar proportion of HIV-positive and HIV-negative participants had intestinal dysfunction (42.2% versus 44.4%) that was worse with advanced disease; an increasing gradient of low D-xylose absorption was noted with decreasing CD4 counts (32%, 50% and 58.3% among those with >350, 200-350 and <200 cells/mm3, respectively). Multivariate analysis revealed a significant association between intestinal dysfunction and low BMI (P=0.03) independent of HIV infection and calorie intake per day (P=0.02).
The findings suggest an underlying prevalence of enteropathy among the rural population in India which makes the HIV-positive population more vulnerable to nutritional compromise and rapid progression of disease. The authors conclude that weight loss in HIV-infected individuals should be investigated for intestinal dysfunction, especially in low-resource settings, to aid appropriate management.
Footnotes
1Isaac R, Paul B, Geethanajali FS, Kang G, Wanke C. (2017). Role of intestinal dysfunction in the nutritional compromise seen in human immunodeficiency virus-infected adults in rural India. Tropical Doctor, Vol.47 (1) 44-48.
More like this
FEX: Generalised Oedema in COVID-19 Positive Children - A Case Series
View this article as a pdf Experiences on COVID-19 and nutrition captured to date in Field Exchange have been at a programme level rather than at individual case management...
FEX: Study of the Risk Factors for the Development of Nutritional Oedema in North Kivu, DRC
By Mark Myatt and Frances Mason Mark Myatt is a consultant epidemiologist and senior research fellow at the Division of Epidemiology, Institute of Opthalmology, University...
FEX: Infant Feeding Patterns and Risk of Death
Summary of published paper1 Current WHO guidelines recommend that HIV positive mothers should avoid breastfeeding only if replacement feeding is acceptable, feasible,...
FEX: Effect of Breastfeeding and Formula Feeding on Transmission of HIV-1
Summary of published clinical trial Transmission of human immunodeficiency virus type 1 (HIV-1) is known to occur through breastfeeding, but the magnitude of risk has not been...
FEX: Early stages of a ‘Food by Prescription’ programme for HIV infected adults
By Elizabeth Bontrager and Kate Sadler Elizabeth Bontrager joined the Feinstein International Centre at Tufts University in 2008, where she coordinates Tufts' involvement in...
NEX: Reframing Undernutrition: Faecally-Transmitted Infections and the 5 As
Summary of IDS Working Paper 450 by Robert Chambers and Gregor von Medeazza, G. Full article available here. Levels of undernutrition persist in much of Asia, despite many...
FEX: Managing severe acute malnutrition in high HIV prevalence areas
Summary of research1 An inpatient facility in Malawi The challenges of managing severely malnourished HIVinfected children in areas of high HIV prevalence are examined in a...
FEX: ODI working paper on reframing undernutrition: faecally-transmitted infections
Despite many initiatives to assure food access, and growing economies, high levels of undernutrition persist in much of Asia. It is increasingly suggested that much of this...
FEX: Vitamin A policies need rethinking
Summary of research1 Location: Global What we know: Vitamin A deficiency (VAD) remains prevalent worldwide. Periodic (6 monthly) high dose distribution of VA has been the...
FEX: Duodenal microbiota in stunted undernourished children with enteropathy
View this article as a pdf Research snapshot1 The link between environmental enteric dysfunction (EED), a disorder of the small intestine, and childhood undernutrition has...
FEX: Patterns of body composition among HIV-infected, pregnant Malawians and famine effects
Summary of research1 Mothers attending antenatal clinic Few studies have examined maternal anthropometry and its predictors during pregnancy in sub-Saharan Africa in the...
FEX: The link between tuberculosis and undernutrition
Research snapshot1 Undernutrition increases the frequency, severity and fatality of many infections, including tuberculosis (TB), while infections, in turn, worsen...
FEX: The impact of HIV on the management of severe malnutrition in Malawi
Summary of published paper There has been remarkably little published on the implications of HIV infection for emergency nutrition interventions. HIV infection is common among...
FEX: Impact of maternal mental health on recovery from severe acute malnutrition in Malawi
View this article as a pdf MSc summer project1 By Mphatso Nancy Chisala Mphatso Chisala is a medic by profession with an interest in the prevention and treatment of child...
FEX: References for Special Supplement 2
Livelihood activities in South Sudan 1. World Health Organisation (WHO), Management of Severe Malnutrition: A manual for physicians and other senior health workers. Geneva:...
FEX: Review of targeting methods in HIV programmes
By Josh Colston Josh Colston studies demography and public health at the London School of Hygiene and Tropical Medicine. In the past he has worked as lecturer in British...
FEX: Antiretroviral Therapy and Nutrition
technical guidance1 Access to antiretroviral drugs (ARVs) is increasing among people living with HIV/AIDS (PLWHA) in developing countries, as a result of local, national, and...
FEX: Cotrimoxazole as a Prophylaxis for HIV Positive Malnourished Children
Summary of review1 By Susan Thurstans, AAH Susan Thurstans is the HIV adviser with Action Against Hunger (AAH), based in Malawi Thanks to Amador Gomez, Technical Advisor,...
FEX: Research Snapshots
The following provides a short summary of each of these important research studies. A fuller summary of each can be found online at www.ennonline.net/fex Inpatient management...
FEX: Review of evidence of role of nutrition in HIV infection
Summary of published research1 A HIV infected mother and HIV infected child receive a voucher that entitles her to a month's supply of CSB and household food items In 2007...
Reference this page
Role of intestinal dysfunction in the nutritional compromise seen in human immunodeficiency virus-infected adults in rural India. Field Exchange 55, July 2017. p19. www.ennonline.net/fex/55/roleofintestinaldysfunction
(ENN_5682)