Prevalence and risk factors of micronutrient deficiencies pre- and post-antiretroviral therapy (ART) among a diverse multicountry cohort of HIV-infected adults

Post Date: 
2016-02-10
   |   
Publication: 
Clinical Nutrition
Summary: 

Background & Aims: HIV-infected adults have increased risk of several individual micronutrient deficiencies. However, the prevalence and risk factors of concurrent and multiple micronutrient deficiencies and whether micronutrient concentrations change after antiretroviral therapy (ART) initiation have not been well described. The objective of this study was to determine the prevalence and risk factors of individual, concurrent and multiple micronutrient deficiencies among ART-naïve HIV-infected adults from nine countries and assess change in micronutrient status 48 weeks post-ART initiation.

Methods:  A random sub-cohort (n = 270) stratified by country was selected from the multinational PEARLS clinical trial (n = 1571 ART-naïve, HIV-infected adults). We measured serum concentrations of vitamins A, D (25-hydroxyvitamin), E, carotenoids and selenium pre-ART and 48 weeks post-ART initiation, and measured vitamins B6, B12, ferritin and soluble transferrin receptor at baseline only. Prevalence of single micronutrient deficiencies, concurrent (2 coexisting) or conditional (a deficiency in one micronutrient given a deficiency in another) and multiple (≥3) were determined using defined serum concentration cutoffs. We assessed mean changes in micronutrient concentrations from pre-ART to week 48 post-ART initiation using multivariable random effects models.

Citation: 
Shivakoti R, Christian P, Yang W-T, Gupte N, Mwelase N, Kanyama C, Pillay S, Samaneka W, Santos B, Poongulali S, Tripathy S, Riviere C, Berendes S, Lama JR, Cardoso SW, Sugandhavesa P, Tang A, Semba RD, Campbell TB, Gupta A for the NWCS 319 and PEARLS study team. Prevalence and risk factors of micronutrient deficiencies pre- and post-antiretroviral therapy (ART) among a diverse multicountry cohort of HIV-infected adults. Clin Nutr. 2015 Feb 10.pii:s0261-5614(15)00045-x. doi: 10.1016/j.clnu 2015.02.002.
Collaborators: 
  • Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 
  • University of Witwatersrand, Johannesburg, South Africa 
  • UNC Lilongwe, Lilongwe, Malawi
  • Durban International Clinical Research Site, Durban University of Technology, Durban, South Africa
  • University of Zimbabwe Clinical Research Centre, Harare, Zimbabwe 
  • Hospital Nossa Senhora de Conceição, Porto Alegre, Brazil 
  • YR Gaitonde Center for AIDS Research and Education, Chennai, India 
  • National AIDS Research Institute, Pune, India 
  • Les Centres GHESKIO, Port-Au-Prince, Haiti
  • Malawi College of Medicine-Johns Hopkins University Research Project, Blantyre, Malawi
  • Asociacion Civil Impacta Salud y Educacion, Lima, Peru
  • STD/AIDS Clinical Research Laboratory, Instituto de Pesquisa Clinica Evandro Chagas, Rio de Janeiro, Brazil
  • Research Institute for Health Sciences, Chiang Mai, Thailand 
  • Tufts University School of Medicine, Boston, MA