Nutritional Interventions for Reducing Morbidity and Mortality in People with HIV

A Cochrane review [Abstract] 1 included 14 studies with 1725 HIV positive adults and 271 HIV positive children.

Neither supplementary food nor daily supplement of Spirulina significantly altered the risk of death compared with no supplement or placebo in malnourished, ART naive adult participants in the two studies which reported on this outcome. A nutritional supplement enhanced with protein did not significantly alter the risk of death compared to standard nutritional care in children with prolonged diarrhoea. Supplementation with macronutrient formulas given to provide protein and/or energy and fortified with micronutrients, in conjunction with nutrition counselling, significantly improved energy intake (3 trials; n=131; MD 393.57 kcal/day; 95% CI 224.66 to 562.47) and protein intake (2 trials; n=81; MD 23.5 g/day; 95% CI 12.68, 34.01) compared with no nutritional supplementation or nutrition counselling alone in adult participants with weight loss. In general supplementation with specific macronutrients such as amino acids, whey protein concentration or Spirulina did not significantly alter clinical, anthropometric or immunological outcomes compared with placebo in HIV-infected adults and children.

Comment: The quality of evidence is downgraded (2 steps) by imprecise results (few patients and wide confidence intervals).

References

• Grobler L, Siegfried N, Visser ME et al. Nutritional interventions for reducing morbidity and mortality in people with HIV. Cochrane Database Syst Rev 2013;2():CD004536. [PubMed]