Background Food insecurity in sub-Saharan Africa and malnutrition constitute the main obstacles for successful treatment of people living with HIV/AIDS (PLWH). The aim of this study was to assess the effect of consuming daily 100 g RUTF (ready-to-use therapeutic food) as supplement, on body composition, anemia and zinc status of hospitalized PLWH in Senegal. Methods A Controlled clinical trial was conducted in 65 PLWH randomly allocated to receive either standard hospital diet alone (Control group: n = 33), or the standard diet supplemented with 100 g RUTF/day (RUTF group: n = 32). Supplementation was continued at home during 9 weeks. Individual dietary intakes were measured and compared to the Recommended Dietary Allowances. Body composition was determined using Bio-Impedance Analysis. Hemoglobin was measured by HemoCue and plasma zinc (PZ) concentration by atomic absorption spectrometry. PZ was adjusted to infection (CRP and α1-AGP). All measures were conducted on admission, discharge and after 9 weeks home-based follow up. Results 34 and 24 % of the patients in RUTF and Control groups were suffering from severe malnutrition (BMI < 16 kg/m 2 ), respectively. In both groups, more than 90 % were anemic and zinc deficiency affected over 50 % of the patients. Food consumed by the Control group represented 75, 14 and 55 % of their daily recommended intake (DRI) of energy, iron and zinc, respectively. When 100 g of RUTF was consumed with the standard diet, the DRI of energy and zinc were 100 % covered (2147 kcal, 10.4 mg, respectively), but not iron (2.9 mg). After 9 weeks of supplementation, body weight, and fat-free mass increased significantly by +11 % ( p = 0.033 ), and +11.8 % ( p = 0.033 ) in the RUTF group, but not in the Control group, while percentage body fat was comparable between groups ( p = 0.888 ). In the RUTF group, fat free mass gain is higher in the patients on ART (+11.7 %, n = 14; p = 0.0001) than in those without ART (+6.2 %, n = 6; p = 0.032 ). Anemia decreased significantly with the supplementation, but zinc status, measured using plasma zinc concentration, remained unchanged. Conclusion Improving PLWH’ diet with 100 g RUTF for a long period has a positive impact on muscle mass and anemia but not on the zinc status of the patients. Trial number NCT02433743 , registered 29 April 2015.
【저자키워드】 HIV/AIDS, Therapeutic food, Fat free mass, Anemia, Zinc, Senegal, 【초록키워드】 Treatment, HIV/AIDS, Anemia, Zinc, clinical trial, Hospitalized, body weight, Infection, CRP, iron, discharge, AIDS, sub-Saharan Africa, ART, Control, plasma, hemoglobin, muscle mass, body composition, Malnutrition, group, Admission, patients, PLWH, food, Concentration, Recommended Dietary Allowances, percentage body fat, on admission, body fat, energy, deficiency, control group, both groups, anemic, atomic absorption spectrometry, Bio-Impedance Analysis, Controlled clinical trial, fat-free mass, plasma zinc concentration, severe malnutrition, status, zinc deficiency, α1-AGP, measure, Registered, positive, fat, Randomly, Result, was measured, affected, significantly, the patient, remained, conducted, adjusted, was determined, comparable, Controlled, were measured, receive, Body, daily recommended intake, Improving, Individual dietary, ready-to-use therapeutic food, standard hospital diet, 【제목키워드】 Randomized controlled trial, Zinc, therapeutic, Daily, anemic status,