Isolated dietary counselling program versus supplement and dietary counselling in patients with human immunodeficiency virus infection

BACKGROUND AND OBJECTIVE: Nutritional intervention is a controversial area. The aim of the study was to compare the influence on nutritional status of nutritional supplementation with a standard polymeric formula as well as nutritional counselling versus isolated nutritional counselling in a group of HIV-infected patients. PATIENTS AND METHOD: There were 70 patients, 66 of whom were fully evaluated for each study end point after application of prospectively determined evaluability criteria. Of these, 35 were randomized to group I (standard formula) and 35 were randomized to unsupplemented group II. Group I patients received standard enteral formula (3 cans/day, 250 ml per can). Patients were submitted to a prospective serial assessment of their nutrition status (anthropometric and biochemical status) and the nutritional intake was determined by means of 24-hours written food records. Determinations were performed at baseline and at 3 months. RESULTS: Treatment with oral supplements in group I resulted in a significant and sustained increase in weight (2.75%; p < 0.05) which was mostly due to fat mass (10.8%; p < 0.05). In contrast, no changes were detected in group 11 patients. The increase in body weight and tricipital skinfold was significant in group 1. Total body water and fat free-mass remained without changes. CD4 counts and viral load remained stable in both groups. CONCLUSIONS: Oral nutritional supplements for a 3-months period resulted in body weight gain in HIV-infected patients, increasing the fat mass. An isolated nutritional counselling did not result in such an increase.