Effects of Micronutrient Supplementation on CD4+ Cell Count and Anthropometric Parameters in HIV-Positive Adults on Highly Active Antiretroviral Therapy and Treatment Naïve in Sokoto, Nigeria

Abstract

Aims: To examine the effects of micronutrient supplementation on CD4+ cell count and anthropometric parameters in 210 HIV-positive adult patients on highly active antiretroviral therapy and treatment naïve. Study Design: A prospective and interventional study was performed comparing five groups receiving daily either a micronutrients (Centrum) supplement or no supplement for 12 months, and the effects of micronutrients supplementation on CD4+ cell count and anthropometric parameters from baseline to 12 months were assessed. Place and Duration of Study: Antiretroviral Therapy Clinic, Usmanu Danfodiyo University Teaching Hospital, Sokoto and Department of Chemical Pathology and Immunology, Usmanu Danfodiyo University, Sokoto, between April, 2013 and September, 2014.  Methodology: We included 210 patients (94 men, 116 women; age range 18-50 years 106 HIV+ HAART-naïve, 104 HIV+ on HAART) with HIV infection and 42 gender, age-and socioeconomically-matched HIV-negative controls. Clinical examination as well as laboratory analysis (CD4+ cell count) and anthropometric parameters (weight and height) were measured using standard techniques at baseline and measurement repeated at 3-monthly period for a total of 12 months. Body mass index was calculated using the expression: BMI (kg/m2) = Body Weight (kg)/Height (m2). Results: The results showed that, CD4+ cell count in HIV-positive HAART-naïve (group B and; 514.65±10.45 and 542.91±21.60 cells/µl respectively) and HIV-positive patients on HAART (group D and E; 655.86±34.62 and 594.77±30.89 cells/µl respectively) were significantly (p<0.001) lower than the corresponding results among age- and gender–matched controls (group A; 952.02±39.15 cells/µl) at baseline. Mean CD4+ cell count, body weight and body mass index increased significantly (p<0.001) in HIV-positive HAART-naïve and HIV-positive patients on HAART that received micronutrients supplement respectively compared to unsupplemented groups. Conclusion: The results in the current study demonstrates that, the CD4+ cell count, body weight, and body mass index were lower in HIV-positive HAART-naïve and HIV-positive on HAART patients at baseline and micronutrient supplementation significantly improved CD4+ cell count reconstitution and body mass index of the subjects. Recommendation: The micronutrient supplement used was tolerated and when given at nutritional doses, is likely to improve the immune reconstitution in HIV-positive HAART-naïve and HIV-positive on HAART patients and may slow the HIV-disease progression and prolong the time before initiation of ART or used as an adjuvant therapy with HAART. This could reduce the morbidity and mortality in the affected HIV/AIDS patients.