Efficacy of 2-month total parenteral nutrition in AIDS patients : a controlled randomized prospective trial

Objective : To evaluate the efficacy of total parenteral nutrition in AIDS patients. Design : A prospective, randomized, controlled, multicentre trial. Methods : Over a period of 2 months, 31 malnourished and severely immunodepressed AIDS patients were assigned to receive either dietary counselling (n = 15) or home total parenteral nutrition (TPN ; n = 16) via a central venous access after an educational program. Results were analysed by intent-to-treat basis. Results : Bodyweight change was +8 kg (+ 13 ± 3%) in the TPN group and - 3 kg (- 6 ± 2%) in the control group (P < 0.0006). Lean body mass increased in the TPN group (+ 9 ± 3%) and decreased in the control group (- 5 ± 3% ; P < 0.004) while body cell mass increased in the former (+ 15 ± 4%) and decreased in the latter (- 12 ± 6% ; P< 0.002). Nutritional subjective global assessment, subjective self-reported health feeling and Karnofsky index were also improved by TPN. Infection line sepsis incidence remained low (0.26 per 100 patient-days). However, no difference in survival rate was exhibited between the two groups by the log-rank test. Conclusion : We conclude that home TPN is an efficient treatment of malnutrition in severely immunodepressed AIDS patients.