A RANDOMIZED CONTROLLED TRIAL EVALUATING NUTRITION COUNSELING WITH ORWITHOUT ORAL SUPPLEMENTATION IN MALNOURISHED HIV-INFECTED PATIENTS

Objective To evaluate the effects of nutrition counseling with or with out oral supplementation in malnourished patients infected with the hu man immunodeficiency virus (HIV). Design Randomized controlled trial. Subjects HIV-infected men (n=118) who were less than 90% of usual weig ht for height or who had lost more than 10% of body weight. Interventi on Nutrition counseling alone (control group) vs nutrition counseling plus enteral supplementation (supplement group) for 6 weeks. AU patien ts were instructed to consume a diet that exceeded estimated total ene rgy expenditure by 960 kcal/day. Main outcome measures Weight, skinfol d thickness, fat-free mass, grip strength, quality of life, and cognit ive function (Buschke test). Statistical analyses Differences in basel ine variables and outcomes were evaluated using analysis of variance o r the Wilcoxon rank sum test. Results Ninety-nine men completed at lea st 4 weeks of treatment, 49 in the supplement group and 50 in the cont rol group. Half the patients in each treatment group achieved at least 80% of their energy target. No differences in weight, skinfold thickn ess measurements, or quality of life were observed. Compared with the control group, the supplement group had larger increases in fat-free m ass and grip strength, although the differences did not reach statisti cal significance. Applications In the short term, nutrition counseling with or without oral supplementation can achieve a substantial increa se in energy intake in about 50% of malnourished HIV-infected patients . Although further study is needed to evaluate long-term effects, thes e findings suggest that nutrition counseling has an important role in the management of malnourished HIV-infected patients.