Nutritional status of HIV seropositive patients in Ashanti Region of Ghana.

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The relationship between HIV/AIDS and nutritional status has been a distinguishing characteristic of the disease course since the earliest days of the epidemic. Since the introduction of Highly active antiretroviral therapy (HAART), there has been divergent views concerning the nutritional status of HIV patients. Therefore to contribute to the sparse information on the nutritional status among HIV infected patients, a comparative cross sectional study was conducted to compare and investigate the nutritional status of participants on HAART and participants who are HAART naïve. In all two hundred and eighty seven (287) confirmed People Living with HIV/AIDS (PLWHAs) consisting of 179 participants on highly active antiretroviral therapy (HAART) and 108 HAART naïve participants were included in the study. The participants were recruited from the antiretroviral (ART) clinics at ST. Michael’s Hospital, Pramso and Bomso specialist clinic, Bomso all in Ashanti region of Ghana. Anthropometry(BMI, MUAC, WHR,TSF, BSF), Complete haemogram, immunological (CD4) and biochemical (albumin, total protein, zinc, transferrin, ferritin, urea, ALP, ALT, AST) analysis were conducted for all the participants. Socio demographic features were collected using an interviewer administered questionnaire. Ethical clearance was obtained from Committee on Human Research, Publications and Ethics (CHRPE), School of Medical Sciences, Kwame Nkrumah University of Science & Technology (KNUST), Kumasi. All participants gave informed consent to take part in the study after verbal and written explanation of the methods and risks involved had been given. Out of the 287 HIV/AIDS Participants categorized into HAART naïve and on HAART participants, 108 were highly active antiretroviral therapy (HAART) naïve participants of which 41were males and 67 were females and 179 participants on HAART of which 48 were males and 131 were females. The ages of participants ranged from 18 to 60. No significant difference was observed in the BMI and MUAC between participants on HAART and participants who are HAART naïve though the mean values of these measurements indicated overweight and obesity. HAART naïve participants had a significantly higher WHR (p=0.016) as a measure of central adiposity as compared to participants on HAART. All anemia incidence among participants on HAART were in the Grade 1 anaemia toxicity grade (54.7%; 98/179) whereas in the HAART naïve participants, there were incidence of Grade 2 (13.9%; 15/108) and Grade 3 anemia (16.7%; 18/108). Microcytic hypochromic anaemia was significantly higher in HAART naïve participants (29.2%) as compared to participants on HAART where no case was recorded. Hypozincaemia, hypoalbuminaemia and low transferrin levels were significantly higher among HAART naïve participants as compared to participants who are on HAART therefore putting HAART naïve participants at greater risk of developing nutritional deficiencies. This study is therefore beneficial in the advocacy for complete assessment of nutritional status in HIV partients before and after the initiation of antiretroviral therapy in Ghana.
A thesis submitted in fulfillment of the requirements for the degree of Master of Philosophy in the Department of Molecular Medicine, School of Medical Sciences by Isaiah Kofi Arhin Kwame Nkrumah University of Science and Technology, Kumasi August, 2015