Nutritional and immunological status and their associations among HIV-infected adults in Addis Ababa, Ethiopia.

Background: In the search for cost-effective interventions to reduce morbidity and mortality in HIV disease, the identification of nutritional status and levels of micronutrients is very important.

Objective: To generate information on the level of energy malnutrition and on vitamin A, zinc, and hemoglobin levels and their relationships with disease status in HIV-infected adults in Addis Ababa, Ethiopia.

Methods: A cross-sectional study was carried out on 153 HIV-positive adults (19% male, 81%female) living in Addis Ababa. The nutritional status and the levels of zinc, retinol, and hemoglobin were determined by anthropometric and biochemical methods. CD4+ counts and C-reactive protein levels were measured by standard methods.

Results: Of the patients, 18% were chronically energy deficient, 71% were normal, and 11% were overweight. Serum zinc levels were low (< 10.7 micromol/L) in 53% of subjects, and serum retinol levels were low (< 30 microg/dL) in 47% of subjects. Low hemoglobin levels (< 12 g/dL) were observed in only 4.72% of the study population. CD4+ counts under 200/mm3 and elevated C-reactive protein levels were both found in 21% of the subjects. CD4+ counts were positively and significantly correlated with hemoglobin (r = 0.271, p < .001), zinc (r = 0.180, p < .033), and body mass index (r = 0.194, p < .017). There were significant negative associations between levels of C-reactive protein and levels of zinc (r = -0.178, p < 0.036 and hemoglobin (r = -0.253, p < .002).

Conclusions: Our results provide evidence that compromised nutritional and micronutrient status begins early in the course of HIV-1 infection. Low serum zinc and vitamin A levels were observed in almost half of the subjects. The clinical significance of low serum zinc and vitamin A levels is unclear, and more research is required.