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Nutritional interventions for reducing morbidity and mortality in people with HIV

  1. Sarah S. N. Mahlungulu2,
  2. Liesl Grobler1,*,
  3. Marianne ME Visser3,
  4. Jimmy Volmink4

Editorial Group: Cochrane HIV/AIDS Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 21 MAY 2007

DOI: 10.1002/14651858.CD004536.pub2

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How to Cite

Mahlungulu SSN, Grobler L, Visser MME, Volmink J. Nutritional interventions for reducing morbidity and mortality in people with HIV. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD004536. DOI: 10.1002/14651858.CD004536.pub2.

Author Information

  1. 1

    University of Cape Town, Institute of Infectious Disease and Molecular Medicine (IIDMM), Observatory, Western Province, South Africa

  2. 2

    East London, South Africa

  3. 3

    Welgemoed, Western Cape, South Africa

  4. 4

    University of Stellenbosch, Faculty of Health Sciences, Tygerberg, South Africa

*Liesl Grobler, Institute of Infectious Disease and Molecular Medicine (IIDMM), University of Cape Town, Faculty of Health Sciences, Anzio Road, Observatory, Western Province, 7925, South Africa. liesl.grobler@uct.ac.za.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Berneis 2000 {published data only}
  • Berneis K, Battegay S, Bassetti S, Nuesch R, Leisibach A, Bilz S, Keller U. Nutritional supplements combined with dietary counselling diminish whole body protein catabolism in HIV-infected patients. European Journal of Clinical Investigation 2000;30(1):87-94.
    Direct Link:
Clark 2000 {published data only}
  • Clark RH, Feleke G, Din M, Yasmin T, Singh G, Khan FA, Rathmacher JA. Nutritional treatment for Acquired Immunodeficiency Virus-associated wasting using B-hydroxy B-methylbutyrate, glutamine and arginine: a randomised, double-blind, placebo-controlled study. Journal of Parenteral and Enteral Nutrition 2000;24:133-139.
de Luis 2003 {published data only}
  • de Luis D, Aller R, Bachiller P, Gonzalez-Sagrado M, de Luis J, Izaola O, Terroba MC, Cuellar L. Isolated dietray counselling program versus supplement and dietary counselling in patients with human immunodeficiency virus infection. Med Clin (Barc) 2003;120(15):565-567.
Karsegard 2004 {published data only}
  • Karsegard VL, Raguso CA, Genton L, Hirschel B, Pichard C. L-Ornithine alpha-Ketoglutarate in HIV infection: Effects on muscle, gastrointestinal and immune functions. Nutrition 2004;20:515-520.
Keithley 2002a {published data only}
  • Keithley JK, Swanson B, Zeller JM, Sha BE, Cohen M, Hershow R, et al. Comparison of standard and immune-enhancing oral formulas in asymptomatic HIV-infected persons: a multicenter randomized controlled clinical trial. Journal of Parenteral and Enteral Nutrition 2002;26(1):6-14.
Keithley 2002b {published data only}

 

Rabeneck 1998 {published data only}
  • Rabeneck L, Palmer A, Knowles JB, Seidehamel RJ, Harris CL, Merkel KL, Risser JMH, Akrabawi SS. A randomised controlled trial evaluating nutrition counselling with or without supplementation in malnourished HIV-infected patients. Journal of American Dietary Association 1998;98:434-438.
Schwenk 1999 {published data only}
  • Schwenk A, Steuck H, Kremer G. Oral supplements as adjunctive treatment to nutritional counselling in malnourished HIV-infected patients: randomised controlled trial. Clinical Nutrition 1999;18(6):371-374.
Shabert 1999 {published data only}
  • Shabert JK, Winslow C, Lacey JM, Wilmore DW. Glutamine-antioxidant supplementation increases body cell mass in AIDS patients with weight loss: a randomised, double-blind controlled trial. Nutrition 1999;15:860-864.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Amadi 2005 {published data only}
  • Amadi B, Mwiya M, Chomba E, Thomson M, Chintu C, Kelly P, et al. Improved nutritional recovery on an elemental diet in Zambian children with persistent diarrhoea and malnutrition. Journal of Tropical Pediatrics 2005;51(1):5-10.
Bakeine 1997 {published data only}
  • Bakeine J, Mathias PM, Mugyeni PN. The effects of early nutritional supplementation with Nutrifil or Corn Soya Blend on the nutritional and immune status of adults with HIV infection in Uganda. Proceedings of the Nutritional Society. 1997; Vol. 56, issue 3:282A.
Bell 1999 {published data only}
  • Bell SJ, Chavali S, Bistrian BR, Connolly CA, Utsunomiya T, Forse RA. Dietary fish oil and cytokine and eicosanoid production during human immunodeficiency virus infection. Journal of Parenteral and Enteral Nutrition 1996;20(1):43-49.
Breuikreuitz 2000 {published data only}
  • Breitkreutz R, Pittack N, Nebe CT, Schuster D, Brust J, Beichert M, Hack V, Daniel V, Edler L, Droge W. Improvement of immune functions in HIV infection by sulfur supplementation: two randomized trials. Journal of Molecular Medicine 2000;78:55-62.
Charlin 2002 {published data only}
  • Charlin V, Carrasco F, Sepulveda C, Torres M, Kehr J. Nutritional supplementation according to energy and protein requirements in malnourished HIV-infected patients. Archives Latinoamerican Nutrition 2002;52(3):267-273.
Chlebowski 1993 {published data only}
  • Cheblowski RT, Beall G, Grosvenor M, Lillington L, Weintraub N, Ambler C, Richards EW, Abbruzzese BC, McCamish MA, Cope FO. Long-term effects of early nutritional support with new enterotropic peptide-based formula vs standard enteral formula in HIV-infected patients: a randomised prospective trial. Nutrition 1993;9(6):554-556.
Comi 1996 {published data only}
  • Comi D, Zambelli A, Meraviglia P, Cargnel A, Martini F. Effects of two different diets on AIDS patients' nutritional status. International Conference on AIDS. 1996; Vol. 11:293.
Craig 1997 {published data only}
  • Craig GB, Darnell BE, Weinsier RL, Saag MS, Epps L, Mullins L, et al. Decreased fat and nitrogen losses in patients with AIDS receiving medium-chain-triglyceride-enriched formula vs those receiving long-chain-triglyceride-containing formula. Journal of the American Dietary Association 1997;97(6):605-611.
de Luis Roman 2001 {published data only}
  • de Luis Roman DA, Bachiller P, Izaola O, Romero E, Martin J, Arranz M, Eiros Bouza JM. Nutritional treatment for acquired immunodeficiency virus. European Journal of Clinical Nutrition 2001;55:1048-1052.
Engelson 1998 {published data only}
  • Engelson ES, Kotler DP, Schur I, Matthews DE. Effect of a high protein diet on protein metabolism in HIV-infected men and women. International Conference on AIDS. 1998; Vol. 12:553.
Gibert 1999 {published data only}
  • Gibert CL, Wheeler DA, Collins G, Madans M, Muurahainen N, Raghavan SS, et al. Randomized, controlled trial of caloric supplements in HIV infection. Terry Beirn Community Programs for Clinical Research on AIDS. Journal of Acquired Immune Deficiency Syndromes 1999;22(3):253-259.
Hellerstein 1994 {published data only}
  • Hellerstein M. Effects of enteral nutrition supplements on HIV disease. International Conference on AIDS. 1994.
Hellerstein 1996 {published data only}
  • Hellerstein MK, Wu K, McGrath M, Faix D, George D, Shackleton CH, Horn W, Hoh R, Neese RA. Effects of dietary n-3 fatty acid supplementation in men with weight loss associated with the acquired immune deficiency syndrome: Relation to indices of cytokine production.. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 1996;11(3):258-270.
Hirschel 1996 {published data only}
  • Hirschel B. Double-blind randomised trial of arginine and omega-3 fatty acids. Oral supplementation in HIV infection. International Conference on AIDS. 1996.
Hoh 1998 {published data only}
  • Hoh R, Pelfini A, Neese RA, Chan M, Cello JP, Cope FO, Abbruzese BC, Richards EW, Courtney K, Hellerstein MK. De novo lipogenesis predicts short-term body-composition response by bioelectrical impedance analysis to oral nutritional supplements in HIV-associated wasting. The American Journal of Clinical Nutrition 1998;68(1):154-163.
Kotler 1998 {published data only}
  • Kotler DP, Fogleman L, Tierney AR. Comparison of total parenteral nutrition and an oral, semielemental diet on body composition, physical function, and nutrition-related costs in patients with malabsorption due to acquired immunodeficiency syndrome. Journal of Parenteral and Enteral Nutrition 1998;22(3):120-126.
Melchior 1996 {published data only}
  • Melchior JC, Chastang C, Gelas P, Carbonnel F, Zazzo JF, Boulier A, Cosnes J, Bouletreau P, Messing B. Efficacy of 2-month total parenteral nutrition in AIDS patients: a controlled randomized prospective trial. The French Multicenter Total Parenteral Nutrition Cooperative Group Study. AIDS 1996;10(4):379-384.
Melchior 1998 {published data only}
  • Melchior JC, Gelas P, Carbonnel F, Zazzo JF, Henzel D, Cosnes J, et al. Improved survival by home total parenteral nutrition in AIDS patients: follow-up of a controlled randomized prospective trial. AIDS 1998;12(3):336-337.
Mendez 1998 {published data only}
  • Mendez D, Glesby M, Muurahainen N, Kotler DP, Tierney AR. Nutritional supplements containing long- or medium-chain triglycerides: effects upon body weight and composition in HIV-infected subjects with less than 100 CD4+ lymphocytes/mm3. International Conference on AIDS. 1998; Vol. 12, issue 42347:843.
Micke 2001 {published data only}
  • Micke P, Beeh KM, Schlaak JF, Buhl R. Oral supplementation with whey proteins increases plasma glutathione levels of HIV-infected patients. European Journal of Clinical Investigation 2001;31(2):171-178.
    Direct Link:
Micke 2002 {published data only}
Ndekha 2005 {published data only}
  • Ndekha MJ, Manary MJ, Ashorn P, Briend A. Home-based therapy with ready-to-use therapeutic food is of benefit to malnourished, HIV-infected Malawian children. Acta Paediatrica, International Journal of Paediatrics 2005;94(2):222-225.
Pichard 1998 {published data only}
  • Pichard C, Sudre P, Karsegard V, Yerly S, Slosman DO, Delley V, Perrin L, Hirschel B. A randomised double-blind controlled study of 6 months of oral nutritional supplementation with arginine and omega-3 fatty acids in HIV-infected patients. Swiss HIV Cohort Study. AIDS 1998;12(1):53-63.
Schwenk 1996 {published data only}
  • Schwenk A, Becker K, Breidenbach M, Schrappe M, Diehl V, Kremer G, et al. Enteral nutrition in AIDS cachexia: controlled study on the role of fibre. International Conference on AIDS. 1996; Vol. 11:102.
Suttmann 1996 {published data only}
  • Suttmann U, Ockenga J, Schneider H, Selberg O, Schlesinger A, Gallati H, Wolfram G, Deicher H, Muller MJ. Weight gain and increased concentrations of receptor proteins for tumor necrosis factor after patients with symptomatic HIV infection received fortified nutrition support. Journal of American Dietary Assocation 1996;96(6):565-569.
Wanke 1996 {published data only}
  • Wanke CA, Pleskow D, Degirolami PC, Lambl BB, Merkel K, Akrabawi S. A medium chain triglyceride-based diet in patients with HIV and chronic diarrhea reduces diarrhea and malabsorption: a prospective, controlled trial. Nutrition 1996;12:766-771.
Winkler 2004 {published data only}
  • Winkler P, Ellinger S, Boetzer AM, Arendt BM, Berthold HK, Rockstroh JK, et al. Lymphocyte proliferation and apoptosis in HIV-seropositive and healthy subjects during long-term ingestion of fruit juices or a fruit-vegetable-concentrate rich in polyphenols and antioxidant vitamins. European Journal of Clinical Nutrition 2004;58(2):317-325.
Wohl 2005 {published data only}
  • Wohl DA, Tien HC, Busby M, Cunningham C, MacIntosh B, Napravnik S, et al. Randomized study of the safety and efficacy of fish oil (omega-3 fatty acid) supplementation with dietary and exercise counseling for the treatment of antiretroviral therapy-associated hypertriglyceridemia. Clinical Infectious Diseases 2005;41(10):1498-1504.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Anabwani 2005
Batterham 2005
  • Batterham MJ. Investigating heterogeneity in studies of resting energy expenditure in persons with HIV/AIDS: a meta-analysis. American Journal of Clinical Nutrition 2005;81(3):702-713.
Chernoff 2002
  • Chernoff DN. The significance of HIV viral load assay precision: A review of the package insert specifications of two commercial kits. Journal of the International Association of Physicians in AIDS Care 2002;1(4):134-140.
Grinspoon 1998
  • Grinspoon S, Corcoran C, Miller K, Wang E, Hubbard J, Schoenfeld D, et al. Determinants of increased energy expenditure in HIV-infected women. American Journal of Clinical Nutrition 1998;68(3):720-725.
Hsu 2005
  • Hsu JWC, Pencharz PB, Macallan D, Tomkins A. Macronutrients and HIV/AIDS: a review of current evidence. http://www.who.int/nutrition/topics/Paper%20Number%201%20-%20Macronutrients.pdf 2005.
Irlam 2005
  • Irlam JH, Visser ME, Rollins N, Siegfried N. Micronutrient supplementation in children and adults with HIV infection. Cochrane Database of Systematic Reviews 2005, Issue 4. [Art. No.: CD003650. DOI: ]
Jadad 1996
  • Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary. Controlled Clinical Trials 1996;17(1):1-12.
Kotler 1999
  • Kotler DP, Rosenbaum K, Wang J, Pierson RN. Studies of body composition and fat distribution in HIV-infected and control subjects. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 1999;20(3):228-237.
Macallan 1993
  • Macallan DC, Noble C, Baldwin C, Foskett M, McManus T, Griffin GE. Prospective analysis of patterns of weight change in stage IV human immunodeficiency virus infection. The American Journal of Clinical Nutrition 1993;58(3):417-424.
Macallan 1995a
  • Macallan DC, Noble C, Baldwin C, Jebb SA, Prentice AM, Coward WA, et al. Energy expenditure and wasting in human immunodeficiency virus infection. New England Journal of Medicine 1995;333(2):83-88.
Macallan 1995b
  • Macallan DC, McNurlan MA, Milne E, Calder AG, Garlick PJ, Griffin GE. Whole-body protein turnover from leucine kinetics and the response to nutrition in human immunodeficiency virus infection. American Journal of Clinical Nutrition 1995;61(4):818-826.
Macallan 1998
  • Macallan DC. Sir David Cuthbertson Prize Medal Lecture. Metabolic abnormalities and wasting in human immunodeficiency virus infection. The Proceedings of the Nutrition Society 1998;57(3):373-380.
Melchior 1997
Ramsay 2003
  • Ramsay C. How do you include trials with more than two groups into a single meta-analysis?. http://www.epoc.uottawa.ca/FAQmultiplegroups2003.pdf 2003; Vol. [Accessed 04/01/2007].
Sandige 2004
  • Sandige H, Ndekha MJ, Briend A, Ashorn P, Manary MJ. Home-based treatment of malnourished Malawian children with locally produced or imported ready-to-use food.. Journal of pediatric gastroenterology and nutrition 2004;39(2):141-146.
Scrimshaw 1997
Wheeler 1998
  • Wheeler DA, Gibert CL, Launer CA, Muurahainen N, Elion RA, Abrams DI, et al. Weight loss as a predictor of survival and disease progression in HIV infection. Terry Beirn Community Programs for Clinical Research on AIDS. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 1998;18(1):80-85.
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