IMPROVED BODY-WEIGHT STATUS AS A RESULT OF NUTRITION INTERVENTION IN ADULT, HIV-POSITIVE OUTPATIENTS

Objective Malnutrition is an important consequence of infection with the human immunodeficiency virus (HIV); involuntary weight loss greater than 10% is one criterion that the Centers for Disease Control and Prevention uses for the diagnosis of acquired immunodeficiency syndrome (AIDS). This study was designed to determine whether nutrition intervention in a group of adult, HIV-positive outpatients affected weight maintenance. Methods We undertook a retrospective review of 175 patient charts from the AIDS Reproductive Health Clinic and the Center for Special Studies at The New York Hospital. Forty-nine charts were excluded because the patient expressed a desire to reduce weight, discontinued medical care, or died. Seven charts were eliminated because of missing data. In the remaining patients (n=119), weights were recorded for the initial clinic contact and for a follow-up visit at least 6 months later. Nutrition intervention completed by a registered dietitian was indicated on 42 patient charts (intervention group); intervention included dietary assessment, intake analysis, appropriate counseling, follow-up, and provision of supplements as needed. The remaining 77 charts did not indicate nutrition intervention; this group was called the nonintervention group. Differences between the intervention and nonintervention groups were analyzed using the two-tailed Fisher exact test and the Mann-Whitney nonparametric test. Results Forty-two subjects (35% of the total) received nutrition intervention, including all of those with gastrointestinal problems (n=10) and wasting (n=11). Individuals in the intervention group gained a significant (P<.02) 1.2+/-11.4 lb (mean +/- standard deviation; median= +3 lb) compared with those in the nonintervention group who lost a mean of 3.5+/-12.8 lb (median= -4 lb). Twenty-six subjects (63%) in the intervention group maintained or gained weight compared with 32 subjects (42%) in the nonintervention group. Conclusion The results of this study suggest that nutrition intervention in HIV-infected persons can improve nutritional status and may lead to an enhanced ability to fight infection.