Menu ENN Search

Role of intestinal dysfunction in the nutritional compromise seen in human immunodeficiency virus-infected adults in rural India

Research snapshot1

Human immunodeficiency virus (HIV) disease progression is often marked by enteropathy, which contributes to malabsorption of macro- and micro-nutrients and to progressive weight loss. Altered intestinal function may also lead to poor absorption of antiretroviral and anti-tuberculosis drugs, resulting in treatment failure. Little is known about the magnitude of intestinal dysfunction in the HIV-infected population, particularly in resource-poor countries such as India. This study investigated the association of intestinal dysfunction in HIV-infected individuals with nutritional status and low serum/plasma levels of antioxidant micronutrients, comparing levels with healthy seronegative controls in a rural population in India.

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: 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: 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: 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,...

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: 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: 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: 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: 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...

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...

en-net: WHO Zika and breastfeeding interim guidance

The main mode of Zika virus transmission is through infected Aedes mosquitoes. However, current widespread transmission of the virus has raised questions as to whether...

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: 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: 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: 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: MUAC Versus Weight-for-Height in Assessing Severe Malnutrition

Summary of published paper1 An infant having MUAC measured during the study in Kenya Current WHO guidelines for the management of severe malnutrition in children recommend...

FEX: Review of WHO guidelines for the inpatient management of severe acute malnutrition

Summary of research1 Location: Global What we know: Optimising SAM management is an important strategy for reducing malnutrition-related mortality. What this article adds: A...

FEX: Global crisis – global action: an international effort to combat the spread of HIV/AIDS

Alarmed by the accelerating epidemic and its global impact, the United Nations General Assembly convened a special session on HIV/AIDS at the highest political level (UNGASS)....

FEX: World Health Organisation Admits Targets on AIDS Drugs May be Unrealistic

In its World Health report 2004, the World Health Organisation (WHO) said that AIDS was the leading single cause of death among adults aged 15-59 around the world and that in...

en-net: Hepatitis virus and breastfeeding

What are the risks of hepatitis virus infection through breastfeeding? And prevention method for Hepatitis mothers and any medical prophylaxis for breastfeeding mother? A...

Resource: SAM in children and infants debate

Objectives The objectives of the Consultation that took place in Geneva from 6 - 7 September 2004 were to: critically review new evidence in relation to the current WHO...

Close

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