PhD defence: Nutritional supplementation of HIV patients – University of Copenhagen

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PhD defence: Nutritional supplementation of HIV patients

Mette Frahm Olsen is defending her PhD thesis

Nutritional supplementation of HIV patients

Effects and feasibility of a lipid-based nutrient supplement among patients initiating ART in Jimma, Ethiopia

Time

4 October 2013 at 13:00

Venue

Auditorium A1-01.01 (Festauditoriet), Bülowsvej 17, 1870 Frederiksberg

Opponents

Associate Professor Lotte Lauritzen (chair), Department of Nutrition, Exercise and Sports, University of Copenhagen

Senior Lecturer Victor Owino, Technical University of Kenya, Nairobi, Kenya

Professor Nick Paton, Department of Medicine, National University of Singapore

Supervisors

Professor Henrik Friis, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark

Associate Professor Pernille Kæstel, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark

Professor Lotte Holm, Department of Food and Resource Economics, Faculty of Science, University of Copenhagen

About the thesis

Although access to medical treatment programmes across Africa has made great progress over the last decade, high mortality rates are still observed among patients during the first few months of treatment. Poor nutritional status has been identified as a strong independent predictor of this early mortality.

Nutritional support is now becoming an integrated part of ART programmes in many African countries. However, support is often based on more or less random products, including supplements developed for children with acute malnutrition, and there is very little evidence for their effects in HIV patients. Also, there is a need to understand patients’ perceptions and use of the supplement they are provided with, to assess the feasibility of nutritional support. 

This thesis is based on a trial in Ethiopia, where we investigated the effects of three months’ nutritional supplementation of adult HIV patients at initiation of medical treatment. The daily supplement consisted of 200 g peanut butter with added vitamins and minerals as well as protein from either whey or soy.

The study’s main findings are that supplementation resulted in a more than three-fold weight gain, compared with ART alone, and with substantially more lean mass gained. This effect was accompanied by improvements in muscle function assessed by grip strength. Moreover, the whey-containing supplement supported immune recovery.

A qualitative substudy found that patients were highly motivated to adhere to supplementation. The main concern among patients regarded the risk of HIV disclosure that home supplementation exposed them to. However, sharing and fasting practices were not barriers for the feasibility of supplementation. The supplement was seen as part of HIV treatment, which meant that many social and religious norms, which usually pertain to food, did not apply to the supplement.

2013, 124 pages, ISBN 978 87 7611 642 2