ABSTRACT
Aims: Nutritional status can be compromised by food insecurity which is common among HIV infected persons. Providing food assistance is expected to improve food insecurity and nutritional status among persons infected with HIV. This study aimed at examining the relationship of participating in the Supplemental Nutrition Assistance Program (SNAP), the largest food assistance program in the United States, with food security and nutritional status among HIV infected adults. Study Design: A cross-sectional study design was used in this study. Place and Duration of Study: This study was conducted in Miami, FL, USA, between April 2011 and August 2012. Methodology: We included 159 HIV infected individuals in this study, 113 participants were SNAP recipients while 46 were not. All study participants were, however, eligible to participate in SNAP. Each participant completed demographic and food security surveys as well as dietary and nutrition status assessment. Statistical analyses were conducted using univariate and multivariate analyses. Results: More than half (56%) of the sample experienced food insecurity and had inadequate intakes of several nutrients. There were no significant differences in food security level and nutritional status between SNAP participants and eligible non-participants, even after controlling for demographic and health characteristics. Individuals with very low food security had 4.7 times increased odds (95% CI: 1.29-17.38) of illicit drugs use, which was prevalent (38%) among HIV+ SNAP participants in Miami. Drug users were more than twice likely to have inadequate intakes of vitamins B1, B2, B6, and zinc, compared to non-drug users. Conclusion: Our results do not support an association between SNAP participation and food security or nutritional status in this cohort of HIV infected individuals with prevalent substance abuse. However, it demonstrates that food insecurity and inadequate nutrient intake continues to be prevalent among HIV infected adults and it is related to drug abuse. Resources need to be identified and targeted at addressing both food insecurity and poor nutritional outcomes among populations of HIV infected adults.
ABSTRACT
The occurrence of intestinal parasites, their regional distribution and their relations to eosinophilia were studied in 133 human immunodeficiency virus (HIV) positive individuals from Honduras. After signing an informed consent, participants answered a socio-demographic and risk factor questionnaire, a complete physical examination, medical history, and a series of laboratory tests. All participants were HIV positive but not acquired immunodeficiency syndrome positive. Of them, 67 percent were co-infected with pathogen and non pathogen parasites. Overall occurrence of nematodes was: 44.3 percent for Trichuris trichiura, 24 percent for Ascaris lumbricoides, 12 percent for Hookworm and 7.5 percent for Strongyloides stercoralis. No cases of Giardia lamblia, acute amebiasis or cryptosporidiasis were diagnosed. Mean eosinophil percents for participants were consistently and significantly higher in infected than in non infected individuals: 22 percent for Hookworm vs 7.2 percent (p < 0.001), 11 percent for Trichuris compared to 5.2 percent (p < 0.001), 13.2 percent compared to 7.5 percent for S. stercoralis (p < 0.05), and 12 percent compared to 6 percent for Ascaris cases (p < 0.05). Helminths and non pathogenic protozoa, as single or mixed infections, occurred among the participants. There was a strong correlation between eosinophilia and helminthiasis infections; however, none was identified between CD4 levels and eosinophilia. Because parasitic infections aggravate malnutrition and promote a disbalanced Th2 response in a potentially immuno-compromised host, their effect on HIV disease progression needs further study, mainly in countries were HIV and parasitic infections are highly prevalent.
Subject(s)
Humans , Animals , Male , Female , Adolescent , Adult , Middle Aged , Eosinophilia , HIV Seropositivity , Intestinal Diseases, Parasitic , Cross-Sectional Studies , Honduras , Intestinal Diseases, Parasitic , Prevalence , Risk Factors , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
Los niveles plasmáticos anormales de lípidos y lipoproteínas han sido reportados en estudios realizados en individuos sintomáticos y asintomáticos infectados con el VIH-1. La hipocolesterolemia e hipertrigliceridemia son los disturbios más frecuentemente observados en las diferentes fases de la progresión de la enfermedad. Estos cambios en el perfil lípidico se encuentran asociados a la activación viral y la consecuente respuesta immune, en especial, la producción de citoquinas. El estado del metabolismo de los lípidos puede ser aún más influenciado por enfermedades oportunistas y la anorexia. En consecuencia, la alteración del metabolismo lipídico podría contribuir a la progresión de la enfermedad, el síndrome de consumo y la elevada mortalidad frecuentemente observada en la infección por VIH-1.