Thesis (D. Tech. (Clinical Technology )) - Central University of Technology, Free State, 2013 / The HIV pandemic in South-Africa has created a new form of vulnerability for
households with regards to food security and nutritional status which are vital
components in the general care of HIV-infected individuals. The risk of nutritional
deficiencies and malnutrition are predictors of disease progression and treatment
in resource limited settings. Furthermore, HIV affects nutritional status by
increasing the energy requirements, reducing food intake, affecting nutrient
absorption and metabolism inadequacies due to cytokine activity and diarrhea.
Several vitamins and minerals are important in fighting HIV infection because
they are required by the immune system and major organs to attack infectious
pathogens. Many of these micronutrients have been found to be deficient in HIVinfected
persons and several studies were launched worldwide to investigate the
feasibility of food assistance and nutrient supplementation. Nutritional
supplementation has been advocated in HIV-infected persons especially in lowincome
countries such as South Africa. Therefore, a study to evaluate the role of
nutritional supplementation in HIV-positive patients becomes necessary,
especially in a developing country such as South Africa. It is against this
background that the present research was initiated to examine the influence of a
nutritional supplement on the immune status and health status of HIVpositive/
AIDS adult individuals.
The aim of the investigation was to determine if supplementation with a mixture
comprised from specific minerals, vitamins and herbs over a period of one year,
affected the haematological status, immune status, viral load and pulmonary
function in forty (40) HIV-infected individuals living in the Mangaung Metropolitan,
RSA.
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A quantitative, open-labeled, before-after clinical trial was conducted at the
Central University of Technology, in Bloemfontein, Free State Province in the
RSA.
Socio-demographic and dietary intake questionnaires were completed. All data
pertaining to anthropometric measurements, haematological status, immune
status, viral load and pulmonary function were obtained my means of using
standard procedures and technological equipment. The data were subjected to
parametric and non-parametric statistical analysis.
The results of the present investigation show that the eating pattern of this
urbanized group of individuals reflects high energy (KJ) and macronutrient
intakes coinciding with sub-optimal intake of Vitamin D and iodine.
Of all the haematological variables the only statistical significant changes
observed were increases in the median erythrocyte sedimentation rate (ESR)
(p=0.0219) and mean cell haemoglobin concentration (MCHC) (p=0.0245) after
six months of nutritional supplementation. At 12 months a statistical significant
decrease in the median CD/CD8 ratio (p<0.0048), median Hematocrit
concentration (p<0.0312), median mean cell volume (MCV) (p<0.0359), and
median RDW (p<0.0273) accompanied a statistically significant increase in the
MCHC (p<0.0003) at 12 months after supplementation.
At 6 months 89% (CI95%: 73%; 96%) of the individuals showed a decline in viral
load counts with a median percentage decline of 34% (CI95%: 73%; 96%). At 12
months 85% [CI95%: 68%; 94%] of the individuals show a decrease in viral load
counts with a median percentage decline of 62.9% (CI95%: 50%; 78.6%) following
the intake of the supplement.
The main findings of the present investigation reveal that 68% (50%-81%) of the
individuals show a statistical median increase (p=0.0302) of 16.9% (11.5%;
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36.1%) in the Peak Expiratory Flow (PEF) at six months. A significant decrease
(p=0.0484) in the median FEF75 of 28.1% (14%; 35.3%) is observed in 70%
(53%-83%) of the individuals after 12 months of exposure to the supplement. No
statistical significant changes are observed for FVC, FEV1, FEV1/FVC and FEF50
over the entire trial period.
The present results suggest that a significant measurable decrease in viral load in
HIV-infected individuals can be obtained by means of subjecting individuals to a
nutritional fortification supplement strategy for 6 months or more.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:cut/oai:ir.cut.ac.za:11462/252 |
| Date | January 2013 |
| Creators | Vermaak, Ernst. |
| Contributors | van den Heever-Kriek, W.M.J., Central University of Technology, Free State. Department of Health Sciences |
| Publisher | Bloemfontein: Central University of Technology, Free State |
| Source Sets | South African National ETD Portal |
| Language | en_US |
| Detected Language | English |
| Type | Thesis |
| Format | 5 299 517 bytes, 1 file, Application/PDF |
| Rights | Central University of Technology, Free State |
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