ORAL SUPPLEMENTS IN HIV-INFECTED PATIENTS WITH CHRONIC WASTING - A PROSPECTIVE TRIAL

Aim: Supplementation with polymeric formula diet was evaluated as seco nd step of a nutritional intervention program for malnourished, but ot herwise clinically stable HIV-infected patients. Patients and Methods: 34 patients with weight loss, without opportunistic infections, diarr hea or fever, not responding to nutritional counselling as first inter vention, were included. They were given 1000 kcal per day as polymeric formula. If further weight loss occurred, dose was increased to 1500 kcal per day. Nutritional status was determined by body weight and bio electrical impedance. Results: After four weeks, 7/34 patients already stopped intake. Only 10/34 patients completed three months of treatme nt. The average intake during three months was 496 +/- 363 kcal/d. Rea sons for drop-out were intervening clinical deterioration in eight, ea rly improvement in six, but intolerance or loss to follow-up in ten pa tients. On average, body weight did not change. Intake of formula diet and weight changes were not correlated. Conclusion: Oral supplements are a feasible, cost-effective and safe treatment of malnutrition, but they are accepted only for short time and in limited amount. To estim ate efficacy of this treatment, clinical reasons for malnutrition must be considered. More effective nutritional treatments are needed for c hronically malnourished HIV infected patients.