AIDS related death in Africa is particularly high within the first few months of medical treatment. The major factor that is the cause of the high mortality rate is malnutrition.
A new collaborative project between the University of Copenhagen and Jimma University, Ethiopia, published in the scientific journal BMJ, has revealed that daily nutritional supplementation for the first three months of medical treatment considerably improves the condition of HIV patients. Nutrition also had a significant impact on the immune system.
“Patients gained three times as much weight as those who took ART without the nutritional supplement. And, in contrast to the medication-only group, the supplement takers didn’t just gain fat — a third of their increased weight came from gained muscle mass. Furthermore, grip strength improved, and thereby the ability of patients to maintain their work and manage daily tasks,” said Dr. Mette Frahm Olsen, who is one of the project researchers.
“The immune cell types typically suppressed by HIV were restored more quickly in patients who received a whey-containing nutritional supplement. In conclusion, the effects of the supplement were measurable, and very relevant for HIV patients living in countries where malnutrition is common,” said Mette Frahm Olsen.
“We know that malnutrition fuels the AIDS epidemic, in part because poor nutrition facilitates the virus’ attack on the human immune system. But today, the significance of nutrition is often ignored because patients gain weight while being treated with ART. As a result, a patient’s doctor may believe, mistakenly, that the patient’s nutritional state has been normalized. However, if the patient has not had an adequate nutritious diet, the weight increase may be without benefit and consist mainly of fat,” said PhD Mette Frahm Olsen.
The study is particularly relevant as a new more aggressive recombinant HIV strain has been identified. The recombinant is called A3/02 and is a cross between the two most common strains in Guinea-Bissau, West Africa, 02AG and A3, and currently only occurs in West Africa.
“HIV is an extremely dynamic and variable virus. New subtypes and recombinant forms of HIV-1 have been introduced to our part of the world, and it is highly likely that there are a large number of circulating recombinants of which we know little or nothing. We therefore need to be aware of how the HIV-1 epidemic changes over time,” said Patrik Medstrand, Professor of Clinical Virology at Lund University.
Angelica Palm, Joakim Esbjörnsson, Fredrik Månsson, Anders Kvist, Per-Erik Isberg, Antonio Biague, Zacarias José Da Silva, Marianne Jansson, Hans Norrgren and Patrik Medstrand. Faster progression to AIDS and AIDS-related death among seroincident individuals infected with recombinant HIV-1 A3/CRF02_AG compared to sub-subtype A3. Journal of Infectious Diseases, November 2013
M. F. Olsen, A. Abdissa, P. Kaestel, M. Tesfaye, D. Yilma, T. Girma, J. C. K. Wells, C. Ritz, C. Molgaard, K. F. Michaelsen, D. Zerfu, S. Brage, A. B. Andersen, H. Friis. Effects of nutritional supplementation for HIV patients starting antiretroviral treatment: randomised controlled trial in Ethiopia. BMJ, 2014; 348 (may15 2): g3187 DOI: 10.1136/bmj.g3187