Supplementary feeding in the care of the wasted HIV infected patient

• Published in: Malawi medical journal Vol. 22; no. 2; pp. 46 - 48
• Main Authors: Manary, Mark, Ndekhat, MacDonald, van Oosterhout, Joep J
• Format: Journal Article
• Language: English
• Published: Malawi The Medical Association Of Malawi 01.06.2010
• Subjects: Adult; Anti-Retroviral Agents - therapeutic use; Arachis; Body Mass Index; CD4 Lymphocyte Count; Female; HIV Infections - complications; HIV Infections - drug therapy; HIV Wasting Syndrome - diet therapy; HIV Wasting Syndrome - economics; Humans; Malawi; Male; Original Research; Quality of Life; Soy Foods; Treatment Outcome; Viral Load; Weight Gain; Zea mays; Malawi
• ISSN: 1995-7262; 1995-7262; 1995-7270
• DOI: 10.4314/mmj.v22i2.58792

Wasting and food insecurity are commonly seen in patients receiving antiretroviral treatment (ART) programs in sub-Saharan Africa and south Asia, and supplementary feeding is often offered in conjunction with ART. Evidence for the effectiveness of such supplementary feeding is scant. A randomised, investigator-blinded, controlled clinical trial of two types of supplementary food, corn/soy blended flour and a ready-to-use peanut butter-based lipid paste, in wasted adults in Blantyre, Malawi is described and the results summarised. A historical control group who did not receive supplementary food is described as well. Provision of about half of the daily energy requirement as a supplementary food for 14 weeks resulted in more rapid restoration of a normal BMI; and the energy-dense, ready-to-use paste was associated with more rapid weight gain than the blended flour. Survival was similar among the 3 groups. The strong association between lower BMI and survival indirectly suggests that there may well be clinical benefit from supplementary feeding in this population. No differences were seen in ART adherence or quality of life with more rapid restoration of BMI. Further research is urgently needed concerning the widespread practice of supplementary feeding in HIV/AIDS care to most effectively utilize this intervention.