Macronutrient Supplement for HIV-Infected Patients Initiating ART

While the advent of effective antiretroviral therapy (ART) in resource limited settings holds promise of making a substantial impact on health and well-being, many HIV-infected persons suffer from lack of nutrition and develop weight loss and wasting, often with severe consequences including death. Background malnutrition in sub-Saharan Africa is very important in HIV given that over 30% of people have insufficient food intake and decrease in weight as measured by decrease in body mass index (BMI) to less than 18 is strongly predictive of death. Even with use of ART, weight loss during first 4 weeks of ART is also associated with death. Most studies to date have paid little attention to utilization of food (macronutrient) as a major tool for nutrition intervention. Thus, national guidelines, while acknowledging the importance of the patients' nutritional status, do not provide specific recommendations due to the lack of rigorous evidence.

We propose a study to determine whether HIV-infected patients with BMI

There is an urgent need to define the influence of nutritional status on patient outcomes in the context of use of ART in resource-limited settings. Findings from the proposed study can have a substantial impact on the management of individual patients and can serve to guide national policy.