Die ysterstatus van pasiente met menslike immuniteitsgebrekvirus voor en na mikronutrientsupplementering

Abstract

Background: Malnutrition is an important clinical manifestation of HIV/AIDS and may be the cause of immunosuppression. Micronutrient deficiencies may change the immune functions of the host and thereby favour the virus. Iron plays an important role in the body and in immunity. Aim: The aim of this study was to dertermine whether micronutrient supplementation would retard the progression of HIV to AIDS. Methods: A prospective, placebo controlled, doubleblind. intervention study was done in the Northwest Province. Subjects were divided into two groups. Group A (n=18) received a multivitamin tablet and an antioxidant in capsule and tablet form. Group B (n=12) received a multivitamin tablet and placebos in capsule and tablet form. The supplementation was continued for a period of six months. Blood samples were taken in the beginning, middle and end of the study. Nutritional status was determined by clinical investigations, anthropometrical measurements, dietary- and biochemical analyses. The quality of life was also measured. Only the baseline and end values are reported. Results: There was a significant decrease (p=0.02) in the zinc intake of the control group from baseline to end. The nutritional status of the two groups compared well with each other. The concentrations of haemoglobin (p=0.013), haematocrit (p=0.048) and serum ferritin (p=0.019) of the experimental group decreased from baseline to end. The increase in serum vitamin C was significant (p=0.019) in the experimental group. In both groups there was a significant decrease in the T-lymphocytes from baseline to end. The viral load of the control group increased (p=0.04) while the CD4:CD8 ratio decreased (p=0.04) significantly. There was no significant difference between the changes in the two groups. Conclusion and recommendations: There was a progression of the illness in both groups but according to the viral load it seemed slower in the experimental group than in the control group. An overload of iron may favour the virus and supplementation with iron is not recommended. A well balanced diet that will provide enough iron to meet the needs of the immune system is recommended.