There are more than 40 million individuals infected with HIV living throughout the world, the majority of these live within the resource-limited world. It has been clear throughout the HIV epidemic that the nutritional status of the host plays an important, independent role in HIV-associated outcomes particularly progression of HIV disease and mortality. Although it would appear to be intuitive that maintenance of or improvement in nutritional status would lead to improved outcomes in HIV infected individuals, few data are available to demonstrate the potential benefits of maintaining nutrition status at normal. There are data that suggest that the use of micronutrients could reduce CD4 count decline and delay death, however micronutrients alone will not support or maintain nutritional status. The overall hypothesis of this application is that the consumption of a nutrient dense protein supplement (NDPS) early in HIV infection will slow disease progression, and that the time from infection with HIV to the initiation of HAART will be prolonged. If this hypothesis is proven to be correct, this type of intervention will result in benefit to the individual, as the need for the use of HAART would be delayed. It would also benefit the health systems, as cost savings would result from a delay in the initiation of HAART. Specifically we propose to enroll 740 HIV infected women in Kenya, with CD4 counts between 350 cells/ Worsening nutritional status is common as HIV infection advances and contributes to poor outcomes. We propose an intervention to maintain and improve nutritional status in HIV-infected women in Kenya who are early in the course of their infection, in an attempt delay the progression of their HIV disease. We will randomize women to either a nutrient dense protein supplement (made from beans, nuts, dried fish and dried fruit) in a porridge that is already used in Kenya or to standard of care (no support of nutritional status) and determine whether the use of this porridge delays the need for participants to begin antiretroviral therapy;the public health implications of such an intervention, if successful, would be significant.Public Health Relevance
| Hong, Steven Y; Hendricks, Kristy M; Wanke, Christine et al. (2013) Development of a nutrient-dense food supplement for HIV-infected women in rural Kenya using qualitative and quantitative research methods. Public Health Nutr 16:721-9 |
