Undernutrition in patients living with the human immunodeficiency virus followed at the outpatient treatment center of the Panzi General Referral Hospital in Bukavu: prevalence and associated factors.

Abstract

Introduction : Undernutrition is one of the main manifestations of the progression of acquired immunodeficiency virus (HIV) infection. It is a major concern for people living with HIV (PLHIV). The aim of this study was to assess the nutritional status of PLHIV and determine the factors associated with undernutrition.
Methods: This is a correlational cross-sectional study conducted at the outpatient therapeutic center (CTA) of the Panzi General Reference Hospital (HGR/PANZI) to identify factors associated with undernutrition in PLHIV undergoing antiretroviral (ARV) treatment for more than 6 months. We compared data from 138 undernourished PLHIV with data from 138 PLHIV without undernutrition. Three parameters were used to define undernutrition, including body mass index (BMI) <18.5 kg/m2, nutritional risk index (NRI) <83.5% for severe undernutrition and NRI = 83.5 to 97.5% for moderate undernutrition, and hypo albuminemia <35g/l. In our study, hypo albuminemia was chosen as the expression of undernutrition. Univariate and multivariate logistic regression was used to determine the association between the various independent factors and undernutrition.
Results: The overall rate of undernutrition was 59.6%. The majority of PLWH patients were women (77.9%) vs. men (22.1%). We found 49.7% of women to be undernourished,
compared with 50.2% of men. There was no statistically significant difference in the distribution of undernutrition by gender (p=0.885). The overall mean age was
42.09±11.77 years, with the proportion of undernourished patients in the 18 to 30 age group slightly higher than the others, at 58.1% versus 41.8%. The factors associated with
undernutrition found in our patients were: average level of dietary diversity (aOR=12.93; 95% CI:6.72-25.38; p<0.001) and high level of dietary diversity (aOR=23.25; 95% CI:17.72-36.32; p<0.001), use of adaptive strategies and presence of oral lesions (aOR=6.84 95% CI:1.47-31.6; p=0.014).
Conclusion: Undernutrition during HIV infection remains a major problem in Bukavu. Early detection strategies for people at risk and management protocols need to be put in place.