NUTRITIONAL EVALUATION AND IMMUNOLOGICAL STATUS ON DISEASE PROGRESSION OF EX-HOMELESS HIV-1 INFECTED PATIENTS

by Dias Carneiro, Leila Abboud

The nutritional status of the individual is one of main features that determine HIV-1 infection and Aids. It is very common that some patients show a progressive weight loss and defficient nutritional status during the course of HIV-1 infection and this could compromise an effective immune response. The aim of this study is to evaluate the effects of hypercaloric diet on patients´ body composition and to correlate it with the clinical and immunological status of HIV-1 infected patients prospectively. Clinical and immunological parameters were evaluated before (N=49) and two (N=32), six (N=12), twelve (N=7) and seventeen (N=6) months after nutritional intervention. The 49 (100%) ex-homeless subjects that arrived at ?Casa de Acolhida Santo Antonio (CASA)? were malnourished. They were evaluated and received clinical, social assistance and nutritional support. At that time we could observe that all the patients displayed increased body weight. After nutritional intervention in a two months follow-up, we observed that 97% patients increased body weight, 47% recovered from infections and only 3% had maintained CD4+ T cell counts decreased. After six months no patients had weight loss, everyone who increased body weight also increased muscle and fat mass and subjects with infections continuous in treatment for that. The clinical, nutritional and immunological status were almost the same in the twelve and seventeen last months of evaluation. At that period new infections or clinical manifestations linked to nutritional status were not observed. CD4+ T cell counts were also increased in the majority of patients and no one showed values bellow 100 cells/ mL. We conclude that nutritional interventions on the group studied was probably important on the efficacy of the immunological response to other infections and it can improve the nutritional status of the subjects. Additionally, we observed that multidisciplinar support was efficient on survival improvement of malnourished subjects of this group.