Malnutrición e infección por el virus de la inmunodeficiencia humana

Identificador:  TDX:611

Handle: https://hdl.handle.net/20.500.11797/TDX611

Autors:  Jimenez Expósito, Maria Jesús

Resum:
OBJETIVES: 1) To determine nutritional status, metabolic status, incidence and severity of malabsorption at different stages of HIV infection, and compared with a control group; 2) To asses the influence of malabsorption on nutritional status and resting energy expenditure (REE) in these patients, as well as, the contribution to weight loss of REE and malabsoprtion.METHODS: Fifty HIV patients were classified into three groups: Group 1 (n = 17), HIV-positive asymptomatic; Group 2 (n = 16), AIDS without opportunistic infection; Group 3 (n = 17), AIDS with active infection. Clinically-healthy subjects (n = 19) were used as controls. Parameters measured were: Anthropometry; Body composition (tetrapolar bioelectrical impedance); REE (open-circuit indirect calorimetry); Malabsorption (triolein breath and D-xylose absorption tests); Serum concentrations of vitamina A, E, copper and zinc, and inflammatory parameters.RESULTS: A total of 86% (n = 43) of the HIV-patients had weight loss, in general of slight-moderate range. The incidence and severity of weight loss was higher in presence of opportunistic infection, although a total of 76% HIV-positive asymptomatic subjects had weight loss. Fat-free-mass (FFM) was significantly lower, and the fat mass was lower (p < 0.05 Group 1; NS Group 2; p < 0.001 Group 3) in the three patients group than in controls.Serum vitamin A and E levels were below the reference range in 28% and 12% patients respectively, but not in controls subjects. The prevalence of vitamin A deficiency increased with the severity of the disease. Fewer patients than controls had values below the reference range regarding serum copper (10% versus 21%; NS), but not regarding serum cinc (34% versus 11%; p < 0.05). Serum concentrations of vitamin A were significantly cor