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PREVALENCE AND CHARACTERISTICS ASSOCIATED WITH MALNUTRITION AT HOSPITALIZATION AMONG PATIENTS WITH ACQUIRED IMMUNODEFICIENCY SYNDROME IN BRAZIL
Desnutrição
Hospitalização
Estado nutricional
Prevalência
Brasil
Humanos
Malnutrition
Hospitalization
Nutritional status
Prevalence
Brazil
Humans
Author
Affilliation
Federal University of Bahia. School of Nutrition. Salvador, BA, Brasil
Federal University of Bahia. School of Nutrition. Salvador, BA, Brasil
Federal University of Bahia. School of Nutrition. Salvador, BA, Brasil
Federal University of Bahia. School of Nutrition. Salvador, BA, Brasil
Duke University. School of Medicine. Durham, NC, United States of America / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brazil
Federal University of Bahia. School of Nutrition. Salvador, BA, Brasil
Federal University of Bahia. School of Nutrition. Salvador, BA, Brasil
Federal University of Bahia. School of Nutrition. Salvador, BA, Brasil
Duke University. School of Medicine. Durham, NC, United States of America / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brazil
Abstract
Brazil's National STD/AIDS Program is considered a model of success worldwide. However, AIDS-associated malnutrition continues in subgroups of Brazilian patients despite access to free highly active antiretroviral therapy (HAART). We aimed to identify the prevalence of malnutrition and associated factors among patients hospitalized with AIDS. Methods: We conducted a cross-sectional nutritional assessment among 127 adults hospitalized with AIDS in Brazil’s third
largest city. Using anthropometric measurements, we determined the prevalence of malnutrition (body mass index
,18.5 kg/m2) at hospitalization. Prevalence ratios of malnutrition by demographic, socioeconomic, and clinical conditions
were estimated using log-binomial regression.
Results: One-third of participants were first informed of their HIV disease during the current hospitalization and recent
treatment interruption was common (71%) among those on HAART. Forty-three percent were malnourished and 35% had
severe weight loss at admission. Patient characteristics independently associated with malnutrition were older age (2%
increased prevalence for each year; 95% confidence interval [CI] 0–4%) and very low daily per capita household income.
Living on ,USD 2.00, USD 2.00–4.99 or USD 5.00–9.99 increased the prevalence of malnutrition by 2.01 (95% CI 1.06–3.81),
1.75 (95% CI 0.92–3.35) and 1.42 (95% CI 0.76–2.65) times, respectively, compared to $USD 10.00 per day. Chronic diarrhea
was marginally associated with malnutrition (RR 1.42; 95% CI 0.99–2.04). Overall, 16% of the patients died during
hospitalization. We observed a trend toward higher in-hospital case fatality among malnourished patients (22% vs. 12% for
patients with and without malnutrition, respectively; chi square P = 0.14).
Conclusions: Unacceptably high rates of malnutrition persist in Brazilians hospitalized with AIDS and our results reinforce
the importance of nutritional evaluations in these patients. Improved early testing and treatment adherence strategies may
continue to help reduce AIDS-related morbidity and mortality in Brazil, yet novel interventions to disrupt the cycle of
poverty, HIV, and malnutrition are also urgently needed.
Keywords in Portuguese
Síndrome de Imunodeficiência AdquiridaDesnutrição
Hospitalização
Estado nutricional
Prevalência
Brasil
Humanos
Keywords
Acquired Immunodeficiency SyndromeMalnutrition
Hospitalization
Nutritional status
Prevalence
Brazil
Humans
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