Changes in body composition and dietary patterns among HIV positive adults on first line Antiretroviral treatment at The AIDS Support Organisation (TASO) Mulago, Kampala

Abstract

Background: There is lack of documented information on changes in body composition along with dietary patterns among PLHIV on first line ART in Uganda. In most HIV clinics in Kampala, patients are weighed almost at every visit; however this practice alone does not give adequate information on nutritional status or effectiveness of the treatment and other interventions. Objective: The study aimed at documenting changes in body composition and dietary pattern of HIV positive adults on first line antiretroviral treatment in the first six weeks and ten weeks of treatment. Design and Methods: A longitudinal study was conducted on 102 HIV positive adults commencing ART at TASO Mulago. Body Mass Index (BMI), Bioelectric Impedance Analysis (BIA) and dietary assessments were performed/used to assess changes in body composition and dietary patterns of the study subjects. Results: The participants were aged 18-59 years old of whom 73.5% were women. Significant changes were observed in mean body weight gain (1.6kg± 4.41, p =0.001), fat mass (0.7kg±2.58, p=0.010), lean mass (0.9kg±3.5, p=0.012), body cell mass (0.6kg±1.7, p=0.002) and BMI (0.4±1.2kg/m2, p=0.003) after 10 weeks of commencement on ART. Underweight reduced by 1.9% and overweight and obesity increased by 1.9% and 1% respectively. However there was no significant change in mean (triceps, biceps and subscapular) skinfold measurement. Both male and female subjects did not meet their daily energy requirements. Females had low intake of iron (<20mg) while the male subjects had low intake of vitamin B1 (<1.2mg) at all contacts. The dietary diversity of the subjects was low (less than six food groups) throughout the study period. Conclusion: Individuals on first line antiretroviral treatment showed an increase in body weight, body fat, lean body mass and body cell mass. Although they met their protein requirement, the energy intake was not adequate. Key Recommendation: Antiretroviral treatment among eligible HIV positive individuals should be scaled up as it improves body weight in terms of lean, fat and body cell mass. Also more emphasis should be given to ways of improving macro and micronutrient intake.