Estado nutricional de pacientes vivendo com HIV/Aids atendidos no Hospital Unversitário da Universidade Federal de Mato Grosso do Sul

Abstract

The nutritional aspects of Aids have been neglected for a long time. The aim of this study was to characterize the nutritional status in patients living with HIV/Aids in two moments: at the commencement and at the end of a twelve-month follow-up. Methodology: a descriptive prospective study involving patients diagnosed with HIV/Aids, assisted at Day Hospital Profª Esterina Corsini of Federal University of Mato Grosso do Sul, from January 2006 to July 2007. The criteria to be eligible for the study were: to be at least 18 years old, to have had the first nutritional assistance after being diagnosed as a HIV/Aids carrier, to have had no antiretroviral treatment. Pregnant women, those under 18, the mentally ill; those not evaluated for the 12 months and Indian descendents were excluded from the research. Programs Microsoft Excell and Epi-Info version 3.4.3 have been used for determining descriptive statistical data. Sociodemographic variables, income, CD4+, virus load, total proteins, albumin, hemoglobin, body mass index (BMI), arm muscle circumference (AMC), diet macronutrients and calories have been considered. The analysis of food intake was carried out with the program Diet PRO 4.0 Professional, so that diet in the first and last nutrition consultation could be calculated. Results: From the 21 patients, 12 were male and 9 female; 8 had not finished high school and 2 were illiterate. Their age ranged from 20 to 50 years; 7 patients worked at home and 6 were involved in services and maintenance jobs. Per capita and food income averages were R$ 380,00 and R$ 280,00, respectively. At the commencement and at the end of the follow-up, 10 and 12 patients, respectively, presented CD4+ ≥ 350 cels/mm3. At the end, 11 patients maintained detectable viral load and in 10 this variable was undetectable. During the period of study, the patients presented total protein values ≥ 6,4 g/dL and 13 were recorded with albumin > 3,4 g/dL. Anemia was present in 12 and 9 patients at the commencement and at the end, respectively. According to BMI, initially there were 3 undernourished patients; at the end, none of them were in that condition and 13 were eutrophic. Overweight occurred in 3 and 7 patients, before and after the follow-up, respectively. AMC showed that 9 and 5 patients were undernourished at different levels before and after the follow-up. At the commencement, overweight was seen in 2 patients; at the end, in 4 and 1 obese. From the 5 undernourished patients, 3 were submitted to antiretroviral therapy (ART). Concerning food intake, after 12 months, 14 patients presented a carbohydrate-balanced diet; 17 patients showed an unbalanced lipid diet and 15 patients presented a protein-balanced diet. Sixteen patients were supposed to have followed the proposed dietetic counseling during the nutrition consultations (average = 4,9); among these, 7 did not take ART. In conclusion, dietetic counseling at the commencement and at the end of the period studied may have contributed to improve the patients´ nutritional status.