Effects of a micronutrient, glutamine, pre- and probiotic enriched liquid supplement on nutritional status and immunity of adults with HIV/AIDS : a pilot study

[摘要] ENGLISH ABSTRACT:INTRODUCTION: The objective of this pilot study was to evaluate the effects ofa new micronutrient, glutamine, pre- and probiotic enriched liquid nutritionalsupplement on the nutritional status and immunity of adults living with HIV/AIDS. Thestudy was designed as a prospective randomised double-blind placebo-controlledtrial. Subjects were HIV-infected male and female adult volunteers (n = 47) froma community-based hospice centre in a peri-urban area in a resource-poor settingand were included irrespective of duration or clinical stage of HIV/AIDS. None of thesubjects received antiretroviral therapy.METHOD: The intervention involved the daily ingestion of 40g (200 ml reconstituted)of either the enriched test product or an lsocalorie carbohydrate placebo for a periodof 12 weeks. Anthropometric assessment (weight, height and triceps skinfoldthickness; mid-upper arm, waist and hip circumferences) was performed at baselineand thereafter every 4 weeks (4 times). Biochemical (serum total protein, serumalbumin and C-reactive protein) and haematological (full blood count andimmunophenotyping) assessment was performed at baseline and again afterweek 12.RESULTS: Statistical analysis of baseline values was performed with Wilcoxontwo-sample tests for comparison between the supplemented and placebo groups.Outcomes were evaluated using analysis of variance with Shapiro-Wilk tests andthereafter either pair-wise t-tests or sign tests (for nonparametric data) were used.Thirty-two subjects completed the trial, 14 in the supplemented group and 18 in theplacebo group. Weight increased significantly in the supplemented group(2.73 ± 3.53 kg, P = 0.013). Triceps skinfold thickness increased significantly in boththe supplemented (p = 0.047) and placebo group (p = 0.001). No other significantanthropometric change was observed. Serum albumin increased significantly in thesupplemented group (p = 0.003) and was associated with a significant decline inC-reactive protein (p = 0.028). Haemoglobin decreased significantly in both groups.A significant decline in CD4+ count was observed in the placebo group while thedecline in the supplemented group did not reach significance.CONCLUSION: Oral nutritional supplementation in limited quantities was welltolerated for a period of 3 months. This study demonstrated that an enrichednutritional supplement was able to promote weight gain and amelioratehypoalbuminaemia and possibly inflammation in adults living with HIV/AIDS in theshort to medium term. The enriched nutritional supplement does not appear to havean effect on the immunity of people with HIV/AIDS. The small sample is a limitationof the study and the conclusions pertain to the test product as a whole and not to anyof its respective ingredients. Although further studies are required to evaluatelong-term feasibility, these findings suggest that the use of an enriched nutritionalsupplement has a role in the management of weight loss in persons with HIV/AIDS.

[发布机构] Stellenbosch University