Malnutrition in HIV: Are patients in early stages of disease and with high CD4 counts spared?

Background High incidence of malnutrition have been reported in patients with a moderate and advanced HIV disease, but data on the nutritional status of patients with early and mild HIV infection are lacking. This study compared the nutritional status of antiretroviral therapy (ART)-naive HIV-positive patients with high CD4 counts receiving care in Kaduna state to HIV negative controls. Materials and Methods Consecutive 90 consenting HIV-infected adults, who were ineligible for ART in the 2013 treatment guideline, were enrolled alongside 90 age-and-sex-matched HIV seronegative healthy individuals, and compared for body mass index (BMI), hemoglobin, serum albumin, vitamin B12, zinc, and copper. Results Majority (77%) of participants in both groups were females, slightly younger than the males (ages 39.0 ± 4.0 vs 40.0 ± 2.2 years, P > 0.05). HIV-negative persons had significantly higher nutritional indices (BMI, serum albumin, vitamin B12, zinc, and copper levels) than HIV-infected patients, whereas the indices were worse in WHO clinical stage II than WHO clinical stage I patients. HIV and marital status were significantly associated with malnutrition. Conclusion WHO clinical stage I/II HIV-infected persons have significantly lower nutritional indices than HIV-negative controls. Significant malnutrition therefore occurs in early HIV infection before the start of anti-retrovirals (ARVs) and the occurrence of opportunistic infections.