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Ernst Vermaak E van den Heever, M Brüssow Z Hattingh and M Viljoen

Nutritional status of HIV naïve individuals in central South Africa and the effect of nutritional supplementation on their viral load and immune status. Ernst Vermaak E van den Heever, M Brüssow Z Hattingh and M Viljoen. AIM

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Ernst Vermaak E van den Heever, M Brüssow Z Hattingh and M Viljoen

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  1. Nutritional status of HIV naïve individuals in central South Africa and the effect of nutritional supplementation on their viral load and immune status Ernst Vermaak E van den Heever, M Brüssow Z Hattingh and M Viljoen

  2. AIM  To determine effect of selected nutritional supplementation administrated daily for 12 months on immune status and viral load of forty (40) HIV-naïve individuals.

  3. PROBLEM STATEMENT  • HIV/AIDS pandemic enters its third decade and case numbers continue to increase. • HIV/AIDS in South Africa rates • amongst the highest in the world.

  4. PROBLEM STATEMENT continue Malnutrition has been an endemic problem in Africa for decades, complicated by a combination of factors, and more recently the impact of HIV/AIDS and tuberculosis.

  5. PROBLEM STATEMENT continue In Southern Africa there arediverse groups of urbanized, peri-urban and informal settlements with low income and poverty stricken communities. The result is not only inadequate nutrition, but also insufficient food diversity.

  6. PROBLEM STATEMENT continue Data on the prevalence of malnutrition, dietary intake and/or supplementation in HIV-infected persons in industrialized countries, is widely available. However, this information is often scarce in South Africa where endemic malnutrition and lack of nutrition management are common.

  7. RESEACH OBJECTIVES • The objectives of the study were to: • Determine the baseline dietary intake of the inclusion population. • Evaluate the impact of the nutritional supplement on the immune status of the inclusion population. • Evaluate the impact of the nutritional supplement on the (HIV) viral load of the inclusion population.

  8. METHODOLOGY

  9. RESULTS Table 1.Baseline energy and macronutrient intake

  10. RESULTS continue Table 2.Baseline fat- and water soluble vitamin intake

  11. RESULTS continue Table 3. Baseline mineral and trace element intake

  12. RESULTS continue Table 4.Immunological parameters and viral load of the HIV-infected individuals at baseline, 6 months, and final visit at 12 months.

  13. SUMMARY NUTRITION: Median and mean energy and macronutrient intake for both male and female HIV-infected individuals were higher than the Estimated Energy Requirement (EER) and Recommended Dietary Intake (RDA).

  14. SUMMARY NUTRITION: Majority of the respondents consumed adequate amounts of nutrients; however an inadequate intake of folate, vitamin D, iodine and selenium was observed.

  15. SUMMARY IMMUNE STATUS: Non statistical decrease in the CD4 and CD8 count At 12 months a statistical significant decrease in the median CD/CD8 ratio (p<0.0048).

  16. SUMMARY VIRAL LOAD : Baseline 51041 copies/ml (RNA) 6 Months 23790 copies/ml P-Value Median 0.0001 12 Months 18197 copies/ml P-Value Median 0.0001

  17. CONCLUSION 1 The eating pattern of this group of individuals reflects a high dietary intake of proteins and carbohydrate coinciding with a decrease in Vitamin D and Iodine intake in a significant number of individuals.

  18. CONCLUSION 2 Although CD4 and CD8 cell counts appears to be unaltered in the present investigation, a statistical significant decrease in the CD4/CD8 ratio (p=0.0048) is observed at 12 months.

  19. CONCLUSION 3 In terms of the primary aim of the present investigation the results suggest that a significant measurable decrease in viral load in HIV-infected individuals can be obtained by means of subjecting individuals to a nutritional fortification supplement strategy

  20. THE WAY FORWARD • Repeat the study with increased sample size. • Add the nutrients under supplied in the diet to nutritional supplement. • Assist the local authority to better the supplementation to staple food of the region.

  21. “Let your food be your medicine and your medicine be your food. Each one of the substances in a man’s diet, acts upon his body and changes it in some way, and upon these changes his whole life depends, whether he be in health, in sickness or convalescent. To be sure, there can be little knowledge more necessary.” Hippocrates (460-377 BC) (Roberts, M. 2011. Healing foods. Pretoria: Briza)

  22. Thank you Ernst Vermaak Tel.: +27 (0) 82 7756 261 E-mail: dejagere@cut.ac.za www.cut.ac.za | Bloemfontein (051) 507 3911 | Welkom (057) 910 3500

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