Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

Abstract

AbstractBackgroundHIV management remains concerning and even more challenging in the frame of comorbidities like malnutrition that favors disease progression and mortality in resource-limited settings (RLS).ObjectiveTo evaluate the correlation between immuno-virological responses and the nutritional profile of HIV-infected individuals receiving antiretroviral therapy (ART).MethodsA cross-sectional study was conducted from October to December 2018 among 146 consenting participants enrolled in two health facilities of the East-Region of Cameroon. Socio-demographic data, basic clinical information and treatment history were collected; blood samples were collected by venipuncture for laboratory analysis (HIV-1 viral load, CD4-CD8 Tcells measurement and biochemical analysis) performed at the “Chantal Biya” International Reference Center”, Yaounde, Cameroon. Nutritional profile was evaluated using anthropometric and biochemical parameters. Data were analyzed using Excel 2016, Graph pad prism version 6 and R.version3.5.0; Spearman correlation was used; with p<0.05 considered statistically significant.ResultsMedian [IQR] age was 42 [33-51] years, 76.0% (111/146) were female and median [IQR] duration on ART was 54 [28-86] months. Of these participants, 11.6% (17/146) were underweight based on the body mass index and 4.7% (7/146) were at the stage of advanced weight loss. According to immunovirological responses, 44.5% (65/146) were immunocompromised (CD4<500 cell/µl) and 75.3% (110/146) had an undetectable viremia (<40 copies/mL). CD4 count inversely correlated with total protein concentration (r=-0.18, p=0.030) and viremia was inversely correlated with total cholesterol (r=-0.65; p=0.001), and positively correlated with total protein (r=0.28; p<0.001) and seemingly with triglycerides (r=0.27; p=0.070) concentrations.ConclusionIn this RLS with patients having about five years of ART-experience, half are immunocompromised while the majority have achieved good virological response. Interestingly, one out of eight patients might be experiencing malnutrition. Specifically, increasing CD4 may favour hypo-proteinemia while increasing viral load may prone hyper-proteinemia and hypo-cholesterolemia. Further studies are needed in RLS with high burden of HIV-infection.