IMPROVED BODY-WEIGHT STATUS AS A RESULT OF NUTRITION INTERVENTION IN ADULT, HIV-POSITIVE OUTPATIENTS

Objective Malnutrition is an important consequence of infection with t he human immunodeficiency virus (HIV); involuntary weight loss greater than 10% is one criterion that the Centers for Disease Control and Pr evention uses for the diagnosis of acquired immunodeficiency syndrome (AIDS). This study was designed to determine whether nutrition interve ntion in a group of adult, HIV-positive outpatients affected weight ma intenance. Methods We undertook a retrospective review of 175 patient charts from the AIDS Reproductive Health Clinic and the Center for Spe cial Studies at The New York Hospital. Forty-nine charts were excluded because the patient expressed a desire to reduce weight, discontinued medical care, or died. Seven charts were eliminated because of missin g data. In the remaining patients (n=119), weights were recorded for t he initial clinic contact and for a follow-up visit at least 6 months later. Nutrition intervention completed by a registered dietitian was indicated on 42 patient charts (intervention group); intervention incl uded dietary assessment, intake analysis, appropriate counseling, foll ow-up, and provision of supplements as needed. The remaining 77 charts did not indicate nutrition intervention; this group was called the no nintervention group. Differences between the intervention and noninter vention groups were analyzed using the two-tailed Fisher exact test an d the Mann-Whitney nonparametric test. Results Forty-two subjects (35% of the total) received nutrition intervention, including all of those with gastrointestinal problems (n=10) and wasting (n=11). Individuals in the intervention group gained a significant (P<.02) 1.2+/-11.4 lb (mean +/- standard deviation; median= +3 lb) compared with those in th e nonintervention group who lost a mean of 3.5+/-12.8 lb (median= -4 l b). Twenty-six subjects (63%) in the intervention group maintained or gained weight compared with 32 subjects (42%) in the nonintervention g roup. Conclusion The results of this study suggest that nutrition inte rvention in HIV-infected persons can improve nutritional status and ma y lead to an enhanced ability to fight infection.