Effects on mortality of a nutritional intervention for malnourished HIV-infected adults referred for antiretroviral therapy: a randomised controlled trial

What this study found

Adding high-dose vitamins and minerals to lipid-based nutritional supplementation did not reduce early mortality. Deaths between recruitment and 12 weeks post-ART were 184 in LNS-VM versus 181 in LNS, with mortality rates of 82.6 versus 83.7 per 100 person-years and a rate ratio of 0.99 (95% CI, 0.80-1.21; P = 0.89). Hospitalization and all serious clinical adverse events were also not significantly different. The intervention improved CD4 count at 12 weeks after ART: adjusted mean difference 25 cells/μL (4-46; P = 0.02). It also increased some electrolyte abnormalities, including potassium…

Study & population

Randomized controlled trial in malnourished, ART-naive adults with HIV and BMI <18.5 kg/m2 who were referred to start antiretroviral therapy in Tanzania and Zambia.

Intervention

Oral ready-to-eat lipid-based nutritional supplement with added vitamins and minerals (LNS-VM) was given in two stages: 30 g/day (about 150 kcal/day) from recruitment to 2 weeks after ART initiation, then 250 g/day (about 1,400 kcal/day) from 2 to 6 weeks after ART initiation.

Key limitation

The follow-up was short, ending 12 weeks after ART initiation, which limits assessment of longer-term clinical benefit.

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