Nutritional aberration and related morphological disorders among patients with human immunodeficiency virus infection on combination antiretroviral therapy (cART) in Ghana: A retrospective study

Background: Metabolic and nutritional abnormalities among people living with human immunodeficiency virus (PLHIV) have been reported due to either their HIV infection, primary malnutrition caused by insufficient intake or consequences of the ART regimen provided. This study investigated the prevalen...

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Main Authors: Percival Delali Agordoh, Sylvester Yao Lokpo, William K.B.A. Owiredu, Verner N. Orish, Clement Okraku Tettey, John Agyemang Sah, Lydia Enyonam Kuatsienu, Louis Selassie Ameke, James Osei-Yeboah
Format: Article
Language:English
Published: Elsevier 2022-08-01
Series:Heliyon
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405844022017248
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author Percival Delali Agordoh
Sylvester Yao Lokpo
William K.B.A. Owiredu
Verner N. Orish
Clement Okraku Tettey
John Agyemang Sah
Lydia Enyonam Kuatsienu
Louis Selassie Ameke
James Osei-Yeboah
author_facet Percival Delali Agordoh
Sylvester Yao Lokpo
William K.B.A. Owiredu
Verner N. Orish
Clement Okraku Tettey
John Agyemang Sah
Lydia Enyonam Kuatsienu
Louis Selassie Ameke
James Osei-Yeboah
author_sort Percival Delali Agordoh
collection DOAJ
description Background: Metabolic and nutritional abnormalities among people living with human immunodeficiency virus (PLHIV) have been reported due to either their HIV infection, primary malnutrition caused by insufficient intake or consequences of the ART regimen provided. This study investigated the prevalence and patterns of nutritional abnormalities including morphological changes among HIV patients under combination Antiretroviral Therapy (cART) in the Bia-West District of the Western North Region. Methods: We employed a hospital-based retrospective longitudinal design. Records of 180 patients with HIV infection before and after antiretroviral therapy (ART) initiation were extracted at the Essam Government Hospital. Eligibility criteria included being on treatment without change in regimen for at least one year and without defaulting in scheduled visits. Data extracted included patients' demography, nutritional parameters and medication history. We assessed patients’ nutritional characteristics with the subjective global assessment (SGA) tool which includes five components of medical history (weight change, dietary intake, gastrointestinal symptoms, functional capacity & metabolic stress) and two components of physical examination (signs of fat loss and muscle wasting, alterations in fluid balance). Results: Malnutrition, lipodystrophy and body wasting among HIV patients were 48.3% (36.5–62.4), 43.9% (32.6–57.7) and 33.3% (23.6–46.0) respectively. Incremental percentage trends of malnutrition (stage I- 7.4%, stage II -22.4%, stage III-24.7%) and lipodystrophy (Stage I - 22.2%, Stage II - 48.7%, Stage III - 51.9%) were significantly associated with worsening disease status. Patients on AZT+3TC + NVP combined regimen presented with the highest malnutrition [52.9% (28.5–76.1)], lipodystrophy [64.7% (38.6–84.7)] and loss of muscle mass [47.1% (23.9–71.5)]. Long-term ART use was significantly associated with high malnutrition rate (p= 0.02620) and increasing muscle mass loss (p = 0.0040). Conclusion: High malnutrition, lipodystrophy and muscle wasting exist in PLHIV on cART in the Bia-West District. These adverse nutritional effects may be modulated by disease severity, ARV medication and duration.
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spelling doaj.art-eeb85da0e0e14d4497d42f92ef775a342022-12-22T02:13:04ZengElsevierHeliyon2405-84402022-08-0188e10436Nutritional aberration and related morphological disorders among patients with human immunodeficiency virus infection on combination antiretroviral therapy (cART) in Ghana: A retrospective studyPercival Delali Agordoh0Sylvester Yao Lokpo1William K.B.A. Owiredu2Verner N. Orish3Clement Okraku Tettey4John Agyemang Sah5Lydia Enyonam Kuatsienu6Louis Selassie Ameke7James Osei-Yeboah8Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana; Corresponding author.Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, GhanaDepartment of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Department of Clinical Biochemistry, Diagnostic Directorate, Komfo Anokye Teaching Hospital, Kumasi, GhanaDepartment of Microbiology and Immunology, School of Medicine, University of Health and Allied Sciences, Ho, GhanaDepartment of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, GhanaLaboratory Department, Essam Government Hospital, Ghana Health Service, Sefwi, Western North Region, GhanaDepartment of Physician Assistantship, Princefield University College and Research Institute, Volta Region, Adaklu, GhanaLaboratory Department, Ho Municipal Hospital, Ghana Health Service, Volta Region, Ho, GhanaDepartment of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, GhanaBackground: Metabolic and nutritional abnormalities among people living with human immunodeficiency virus (PLHIV) have been reported due to either their HIV infection, primary malnutrition caused by insufficient intake or consequences of the ART regimen provided. This study investigated the prevalence and patterns of nutritional abnormalities including morphological changes among HIV patients under combination Antiretroviral Therapy (cART) in the Bia-West District of the Western North Region. Methods: We employed a hospital-based retrospective longitudinal design. Records of 180 patients with HIV infection before and after antiretroviral therapy (ART) initiation were extracted at the Essam Government Hospital. Eligibility criteria included being on treatment without change in regimen for at least one year and without defaulting in scheduled visits. Data extracted included patients' demography, nutritional parameters and medication history. We assessed patients’ nutritional characteristics with the subjective global assessment (SGA) tool which includes five components of medical history (weight change, dietary intake, gastrointestinal symptoms, functional capacity & metabolic stress) and two components of physical examination (signs of fat loss and muscle wasting, alterations in fluid balance). Results: Malnutrition, lipodystrophy and body wasting among HIV patients were 48.3% (36.5–62.4), 43.9% (32.6–57.7) and 33.3% (23.6–46.0) respectively. Incremental percentage trends of malnutrition (stage I- 7.4%, stage II -22.4%, stage III-24.7%) and lipodystrophy (Stage I - 22.2%, Stage II - 48.7%, Stage III - 51.9%) were significantly associated with worsening disease status. Patients on AZT+3TC + NVP combined regimen presented with the highest malnutrition [52.9% (28.5–76.1)], lipodystrophy [64.7% (38.6–84.7)] and loss of muscle mass [47.1% (23.9–71.5)]. Long-term ART use was significantly associated with high malnutrition rate (p= 0.02620) and increasing muscle mass loss (p = 0.0040). Conclusion: High malnutrition, lipodystrophy and muscle wasting exist in PLHIV on cART in the Bia-West District. These adverse nutritional effects may be modulated by disease severity, ARV medication and duration.http://www.sciencedirect.com/science/article/pii/S2405844022017248Nutrition aberrationMalnutritionMorphological disordersHIVcART
spellingShingle Percival Delali Agordoh
Sylvester Yao Lokpo
William K.B.A. Owiredu
Verner N. Orish
Clement Okraku Tettey
John Agyemang Sah
Lydia Enyonam Kuatsienu
Louis Selassie Ameke
James Osei-Yeboah
Nutritional aberration and related morphological disorders among patients with human immunodeficiency virus infection on combination antiretroviral therapy (cART) in Ghana: A retrospective study
Heliyon
Nutrition aberration
Malnutrition
Morphological disorders
HIV
cART
title Nutritional aberration and related morphological disorders among patients with human immunodeficiency virus infection on combination antiretroviral therapy (cART) in Ghana: A retrospective study
title_full Nutritional aberration and related morphological disorders among patients with human immunodeficiency virus infection on combination antiretroviral therapy (cART) in Ghana: A retrospective study
title_fullStr Nutritional aberration and related morphological disorders among patients with human immunodeficiency virus infection on combination antiretroviral therapy (cART) in Ghana: A retrospective study
title_full_unstemmed Nutritional aberration and related morphological disorders among patients with human immunodeficiency virus infection on combination antiretroviral therapy (cART) in Ghana: A retrospective study
title_short Nutritional aberration and related morphological disorders among patients with human immunodeficiency virus infection on combination antiretroviral therapy (cART) in Ghana: A retrospective study
title_sort nutritional aberration and related morphological disorders among patients with human immunodeficiency virus infection on combination antiretroviral therapy cart in ghana a retrospective study
topic Nutrition aberration
Malnutrition
Morphological disorders
HIV
cART
url http://www.sciencedirect.com/science/article/pii/S2405844022017248
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