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首页> 外文期刊>AIDS care. >The benefit of supplementary feeding for wasted Malawian adults initiating ART.
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The benefit of supplementary feeding for wasted Malawian adults initiating ART.

机译：浪费食物的马拉维成年成年人补充营养的好处。

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Food insecurity is considered to be an important contributor to HIV associated wasting in sub-Saharan Africa. Low body mass index (BMI) is a strong risk factor for early mortality during antiretroviral therapy (ART). Nutritional supplementation has become standard of care in wasted patients starting ART in many countries in the region, but there is no unequivocal evidence base for this intervention. Against this background, we performed a retrospective study to compare food supplementation versus no nutritional intervention in wasted adults starting ART in Blantyre, Malawi. All patients received free nevirapine, lamivudine, and stavudine. Participants in an effectiveness trial of two food supplements received either corn-soy blend (CSB) or ready-to-use food spread (RUFS) during the first 14 weeks of ART. Results were compared with a historical control group receiving no food supplement that was part of an observational cohort study of outcomes of the same ART regimen. Characteristics on initiation of ART were similar in the three groups, except the use of cotrimoxazole prophylaxis which was more frequent in the food-supplemented groups. Linear regression analysis showed that increase in BMI was greatest in the RUFS group and better in the CSB group than in those receiving no food supplementation at 14 weeks. These differences were no longer significant at 26 weeks. Lower BMI, CD4 count and hemoglobin, WHO clinical stage IV, male gender, and not receiving cotrimoxazole prophylaxis were independent risk factors for mortality at 14 and 26 weeks in the logistic regression analysis. Supplementary food use was not directly associated with improved survival.
机译：粮食不安全被认为是造成撒哈拉以南非洲与艾滋病毒有关的浪费的重要原因。低体重指数（BMI）是抗逆转录病毒治疗（ART）期间早期死亡的重要危险因素。在该地区许多国家，营养补充已成为开始接受抗逆转录病毒疗法的虚度患者的护理标准，但是这种干预措施没有明确的证据基础。在此背景下，我们进行了一项回顾性研究，以比较在马拉维布兰太尔开始接受抗逆转录病毒疗法的浪费成人中的食物补充与无营养干预之间的差异。所有患者均接受免费的奈韦拉平，拉米夫定和司他夫定治疗。两种食品补充剂有效性试验的参与者在抗逆转录病毒治疗的前14周内接受了玉米大豆混合食品（CSB）或即食食品涂抹食品（RUFS）。将结果与未接受食物补充的历史对照组进行比较，这是同一ART方案结局的观察性队列研究的一部分。在三组中，ART起始的特征相似，除了在食物补充组中更频繁使用cotrimoxazole预防剂。线性回归分析显示，RUFS组的BMI增幅最大，而CSB组的BMI增幅则好于在14周时未添加任何食物的BMI。这些差异在26周时不再显着。在Logistic回归分析中，较低的BMI，CD4计数和血红蛋白，WHO临床分期IV，男性和未接受cotrimoxazole预防是死亡14周和26周时死亡的独立危险因素。补充食物的使用与存活率的提高没有直接关系。

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