Document Detail


Poor diet quality is associated with low CD4 count and anemia and predicts mortality among antiretroviral therapy-naive HIV-positive adults in Uganda.
MedLine Citation:
PMID:  23117502     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We assessed the association between dietary diversity and CD4 count, moderate anemia, and mortality among 876 antiretroviral therapy-naive people living with HIV/AIDS infection (PLHIV) in Uganda.
METHODS: Participants were interviewed and followed for an average of 21.6 months. Dietary diversity was measured using the Individual Dietary Diversity Score (IDDS) (range, 0-12) and summarized into an overall measure and disaggregated into nutrient-rich food groups (range, 0-7), cereals, roots, and tubers (range, 0\x{2013} 2); and oils, fats, sugars, and condiments (range, 0\x{2013} 3). We determined the cross-sectional associations between dietary diversity and (1) immunosuppression (CD4 count ≤ 350 cells/μL) and (2) moderate anemia (hemoglobin < 10 g/dL) at baseline with logistic regression. We assessed the association between IDDS and mortality using Cox proportional hazards regression.
RESULTS: The mean IDDS score was 6.3 (SD 1.7) food groups per day, with a mean of 2.7 (SD 1.1) nutrient-rich food groups per day. Each additional nutrient-rich food group consumed was associated with a 16% reduction in the likelihood of having a CD4 count ≤350 cells/μL [adjusted odds ratio, 0.84; 95% confidence interval (CI): 0.72 to 0.97] at baseline. Among those with >350 CD4 cells per microliter, but not those with CD4 count ≤350 cells per microliter, consumption of nutrient-rich food groups was associated with a lower odds of moderate anemia (adjusted odds ratio, 0.57; 95% CI: 0.34 to 0.96). During follow-up, 48 participants (5.6%) died (mortality rate of 3.1 per 100 person-years). IDDS was inversely associated with mortality [adjusted hazard ratio, 0.76; 95% CI: 0.63 to 0.91].
CONCLUSION: These results suggest that diet quality is an important determinant of HIV disease severity and mortality in antiretroviral therapy-naive PLHIV.
Authors:
Rahul Rawat; Sandra I McCoy; Suneetha Kadiyala
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  62     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-18     Completed Date:  2013-03-08     Revised Date:  2014-01-07    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  246-53     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anemia / etiology
Anti-Retroviral Agents / therapeutic use
CD4 Lymphocyte Count
Confidence Intervals
Cross-Sectional Studies
Diet / adverse effects*
Female
Food Habits*
HIV Infections / drug therapy,  immunology,  mortality*
Hemoglobins / metabolism
Humans
Male
Middle Aged
Nutritive Value*
Odds Ratio
Proportional Hazards Models
Prospective Studies
Uganda / epidemiology
Grant Support
ID/Acronym/Agency:
K01 MH094246/MH/NIMH NIH HHS; K01MH094246/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Retroviral Agents; 0/Hemoglobins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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