The influence of a multiple combination liquid product on the immune status of HIV-positive/AIDS patients

Abstract

The relationship between nutrition and HIV infection/AIDS is well recognised. HIV infection compromises the nutritional status of infected persons and in turn, poor nutritional status affects the progression of HIV infection. Nutritional supplementation has been shown to be associated with a significant slowing of disease progression, assists in maintaining and· optimising the nutritional status and the immune function of HIV-infected persons. The value of nutritional supplementation on the immune function of HIV-positive/AIDS patients from low socio-economic communities in the Free State is not yet known. Hence, the main purpose of this study was to determine the influence of a nutritional supplement (Africa's Solution) on the immune status of HIVpositive/ AIDS patients from the low socio-economic communities of Bloemfontein in the Free State Province. The study entailed a clinical trial that consisted of one screening visit and three monthly visits. A total of 35 respondents were selected according to specific inclusion criteria. Food frequency questionnaires were completed during the screening visit. Haematological parameters, CD4+T-cell counts and CD8+T-cell counts were determined at the screening visit, monthly visits and by the end of nutrient supplementation (final visit). The patients studied, demonstrated energy and dietary intake of major macronutrients, higher than the RDNAI and higher (P<O.05) in the male than in the female subjects. It was also observed that the mineral and trace element intakes exceeded the RDNAI, except for iodine and selenium. A majority of the patients reported adequate intake of most vitamins with the exception of folate and vitamin D. It is envisaged that the high dietary intake of major macronutrients and micronutrients would help in maintaining the nutritional status and in curtailing wasting in the patients. The anthropometric profiles and the viral load were determined at baseline (n= 35) and at the end of study (n=28). There was no significant difference (P>O.05) in the fat percentage and body weight before and after nutrient supplementation; however, fat percentage differed significantly (P<O.05) between genders. The body mass index (BMI) and the lean body mass (LBM) produced a trend towards an improvement. There was a positive correlation between BMI and fat percentage. The CD4+T-cell count showed no correlation with the anthropometric profiles, while the viral load showed a negative correlation with the LBM, the fat percentage and the BMI. Results of the influence of the supplement on the immune status, haematological and clinical conditions showed that the viral load decreased significantly (P<0.002) with time following supplementation. The mean cell volume (MCV) and the mean cell haemoglobin concentration (MCHC) increased significantly (P<0.002, P<0.0002 respectively), reflecting the positive effect of the supplement on a few of the haematological parameters. The supplement demonstrated no effect on the CD4+T-cell count and the CD4+T-cell count decreased significantly (P<0.05) with HIV disease progression. The non-positive effect of the supplement on the CD4+T-cell count may be related to the already low CD4+T-cell counts before supplementation (lower than 200 cells/mm3 in the majority of patients); short duration; inter-assay variation; changes due to inter-current illness; impaired production of CD4+T -cells; red istribution within the intravascular spaces and drug-nutrient interactions. The supplement showed observable positive effects on the general well-being (clinical conditions) of the patients. Although, the nutritional supplement did not indicate a positive effect on the CD4+T-cell counts, the reduction in the viral load is very important, since median survival time is known to increase with reduction in HIV viral load. Because of certain limitations (small sample size, short duration, late stage of the infection and inter-assay variation), further study is needed to confirm the efficacy of the supplement.