Nutrition and HIV Progression

营养与艾滋病毒进展

• 批准号: 8067977
• 负责人: Christine A Wanke
• 金额: $ 30.43万
• 依托单位: TUFTS UNIVERSITY BOSTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-20 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8067977
• 关键词: Acquired Immunodeficiency Syndrome; Adherence; Adverse effects; Africa; Body Weight decreased; CD4 Lymphocyte Count; Cells; Cessation of life; Communities; Consumption; Cost Savings; Data; Dietary intake; Disease; Disease Progression; Effectiveness of Interventions; Enrollment; Epidemic; Fishes; Fruit; HIV; HIV Infections; HIV Seropositivity; Health; Health system; Healthcare; Highly Active Antiretroviral Therapy; Individual; Infection; Intervention; Intervention Studies; Kenya; L Cells; Lead; Life; Maintenance; Malnutrition; Measures; Micronutrients; Morbidity - disease rate; Nutrient; Nutritional status; Nuts; Opportunistic Infections; Outcome; Participant; Play; Pregnant Women; Proteins; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recruitment Activity; Resources; Role; Symptoms; Time; Visit; Weight; Woman; antiretroviral therapy; bean; cost effective; cost effectiveness; improved; mortality; nutrition; standard of care; successful intervention

DESCRIPTION (provided by applicant): 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/<L and 500 cells/<Land no symptoms, opportunistic infections or AIDS defining illnesses or malnutrition (BMI <18.5 kg/m2) that would require the initiation of HAART. These individuals with early disease will be randomized to a group that will be provided with the nutrient dense protein supplement (NDPS) or standard of care (SOC) and followed until the initiation of HAART is necessary or a total of 2 years. Outcomes in this study will include the need for the initiation of HAART, the rate of decline of CD4 cell count, overall nutritional status as measured by BMI and lean body mass, and quality of life. We will determine the cost effectiveness of this intervention strategy. In order determine if the dietary intake and the nutritional status (BMI) of the HIV-infected women with early disease is within the community norm, we need to evaluate the dietary intake and nutritional status of similar but non HIV-infected women in the local community. We propose to collect data on 200 women who are documented to be HIV-negative from Voi Division at a single visit, the Division that will also provide the HIV -infected women for the intervention study.

描述（由申请人提供）：全世界有超过 4000 万艾滋病毒感染者，其中大多数生活在资源有限的世界。在整个艾滋病毒流行过程中，很明显，宿主的营养状况在艾滋病毒相关结果尤其是艾滋病毒疾病进展和死亡率中发挥着重要的、独立的作用。尽管从直觉上看，维持或改善营养状况将改善艾滋病毒感染者的预后，但很少有数据可以证明维持正常营养状况的潜在好处。有数据表明，使用微量营养素可以减少 CD4 计数下降并延迟死亡，但仅微量营养素并不能支持或维持营养状态。该申请的总体假设是，在HIV感染早期摄入营养密集的蛋白质补充剂（NDPS）将减缓疾病进展，并且从感染HIV到开始HAART的时间将会延长。如果这一假设被证明是正确的，这种类型的干预将为个人带来好处，因为使用 HAART 的需要将被推迟。它还将使卫生系统受益，因为推迟启动高效抗逆转录病毒疗法可节省成本。具体来说，我们建议在肯尼亚招募 740 名 HIV 感染妇女，其 CD4 计数在 350 个细胞/<L 至 500 个细胞/<L 之间，并且没有任何症状、机会性感染或 AIDS 定义的疾病或营养不良（BMI <18.5 kg/m2），这需要启动HAART。这些早期疾病患者将被随机分配到一组，接受营养密集型蛋白质补充剂 (NDPS) 或标准护理 (SOC)，并进行随访，直至需要开始 HAART 或总共 2 年。这项研究的结果将包括开始HAART的需要、CD4细胞计数的下降率、通过BMI和去脂体重衡量的整体营养状况以及生活质量。我们将确定该干预策略的成本效益。为了确定早期患病的HIV感染女性的膳食摄入和营养状况（BMI）是否在社区正常范围内，我们需要评估当地类似但非HIV感染女性的膳食摄入和营养状况。社区。我们建议一次性从 Voi 部门收集 200 名 HIV 阴性女性的数据，该部门还将为干预研究提供 HIV 感染女性。