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[Nutritional status of patients with HIV infection. Spontaneous evolution during the hospital stay]
D del Olmo1, V Alcázar, R Barba
1S. de Endocrinología y Nutrición, Hospital Severo Ochoa, Leganés, Madrid, España.
Unlabelled:
BASICS: Evaluate the nutritional status of HIV positive patients who are admitted to hospital for some acute process, and their evaluation, without nutritional support, during the admission.
Methods:
Prospective study in HIV positive patients. Nutritional evaluation (on admission and on release); (1) anthropometric (weight, size, triceps, fold, circumference of the arm, and muscular circumference of the arm, and (2) biochemical (albumin, cholesterol, triglycerides, lymphocytes, pre-albumin, and transferrin). Statistical study: comparison of the paired means and chi squared test.
Results:
60 patients. Mean age 32 +/- 4.8 years, 76% men and 23% women. Staging: AIDS 84.8%, non-AIDS 15.2%. Main reason for admission: Infection (80%). Mean stay: 14 days +/- 9.5. Initial nutritional evaluation: normal: 1.7%, protein malnutrition: 5.3%, caloric malnutrition: 38.5%, mixed malnutrition: 54.3%, 85% of the patients refer weight loss. 21 patients (35%) were followed up. There were no significant differences in the anthropometric nor in the biochemical parameters, except in the levels of pre-albumin and transferrin, which improved (p < 0.001). Nutritional evaluation on release: normal: 9.5%, caloric malnutrition: 66.5%, mixed malnutrition: 23.7%. There were no cases of protein malnutrition.
Conclusions:
The vast majority of the HIV+ patients who are admitted, are malnourished, and after curing the acute process, 90.5% of them remain malnourished. The anthropometric measurements, albumin, cholesterol, and triglycerides do not vary during the hospital admission, despite the treatment and the clinical improvement. The increase of proteins with a short half life is due to controlling the infection, which is why these are not good parameters for the nutritional evaluation in these patients.