Effects of oral nutritional supplementation on the intestinal mucosa of patients with AIDS

Weight loss is a major component of the clinical syndrome in patients with acquired immunodeficiency syndrome (AIDS). The impact of malnutrition on th e outcome of the disease has been unappreciated in many investigations. The authors evaluated the effects of oral nutritional supplementation on the m orphology and immunology of the intestinal mucosa of patients with AIDS. Tw elve patients with AIDS without diarrhea or opportunistic infections, with at least 10% of body weight loss over 1 year, were submitted to anthropomet ric measures, peripheral blood T-lymphocyte counts, and peroral jejunal bio psy before and after oral nutritional supplementation. An industrialized pe ptide-based formula containing omega-3 fatty acids was given for 6 weeks. J ejunal samples were analyzed by histomorphometry, including villous-to-cryp t ratio, lamina propria, and intraepithelial lymphocyte count. Immunologic assessment of the intestinal mucosa was made by indirect immunoperoxidase u sing monoclonal antibodies against CD3, CD4, and CD8. Seven patients with i rritable bowel syndrome and two healthy volunteers were selected as a contr ol group for histologic and immunohistochemical comparisons. After 6 weeks the patient group maintained their body weight and increased their tricipit al fold. The number of peripheral blood T cells, albumin, transferrin, and the number of CD3+, CD4+, and CD8+ cells in jejunal mucosa as well as the i ntestinal morphometry remained stable. Oral supplementation contributed to maintaining body weight and may constitute a reasonable adjuvant therapeuti c tool against AIDS progression.