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 A IDS patients. Design: A prospective, randomized, controlled, multicent re trial. Methods: Over a period of 2 months, 31 malnourished and seve rely immunodepressed AIDS patients were assigned to receive either die tary 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 wa s +8 kg (+13 +/- 3%) in the TPN group and -3 kg (- 6 +/- 2%) in the co ntrol 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) wh ile body cell mass increased in the former (+15 +/- 4%) and decreased in the latter (-12 +/- 6%; P<.002). Nutritional subjective global asse ssment, subjective self-reported health feeling and Karnofsky index we re also improved by TPN. Infection line sepsis incidence remained low (0.26 per 100 patient-days). However, no difference in survival rate w as 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.