ASSESSMENT OF MICRONUTRIENT STATUS IN PEOPLE LIVING WITH HIV/AIDS ATTENDING ANTIRETROVIRAL CLINIC IN OYO STATE, NIGERIA

Abstract

Human Immunodeficiency Virus (HIV) infection continues to have impact on the nutritional status of those affected by the disease. Micronutrients act as important modulators of viral and bacterial metabolism in HIV infection and AIDS. In Nigeria, micronutrient deficiencies in People Living with HIV/AIDS (PLWHA) have not been fully documented. Knowledge of micronutrient status is required for effective management of HIV/AIDS. This study therefore assessed the micronutrient levels and its relationship with CD4 cell counts in PLWHA receiving treatment in selected Anti-Retroviral Clinics (ART) in Oyo State, Nigeria. This was a descriptive cross-sectional study in which PLWHA attending antiretroviral clinics in Adeoyo Maternity Hospital, Ibadan and State Hospital Oyo, Oyo State, were selected using systematic random sampling based on their ART status. Two hundred and twenty-two ART and 179 pre- ART participants were recruited respectively until the total sample size of 401 was attained. An interviewer-administered questionnaire was used to obtain information on socio-demographic/anthropometric characteristics: age, sex, weight, height, waist and hip circumference were measured and body mass (BMI) calculated. Secondary data were employed for CD4 cell counts. Blood sample was collected and digestion of the sample was done by the addition of 1NHN03 Levels of micronutrients (Cu, Fe, Zn, Cr and Mn) were measured using Atomic Absorption Spectrophotometer and compared with the reference values, Copper (70-133|ig/dl), Iron (60-175ng/dl), Zinc (65-145|ig/dl), Chromium (140-1400ng/l), Manganese (4-15^g/l) and CD4 cell counts (>200 cells/fil). Data were analysed with descriptive statistics, Chi-square test, correlation, logistic regression and ANOVA at p=0.05. iThe demographic characteristics of the participants among ART and pre-ART were age 39.44±9.65, 40.55±9.71 years, primary education, 43.1%, and 30.1%, married, 73.2% and 81.9% respectively. Anthropometric measurements were: BMI 16.75±2.2kg/m2 and 14.0±2.5kg/m2, waist circumference 29.3±2.6 cm and 31.5±2.9 cm, hip circumference 28.2±2.8 cm and 27.9±2.6 cm and waist/hip ratio 0.79±0.05 cm and 0.87±0.04 cm. The proportion of underweight among ART and pre-ART were 11.2% and 9.7%. The CD4 cell counts for ART were 557.2±280.9 cells^L and pre-ART were 232.4±110.9 cells/^L. The CD4 cell counts showed weak correlation with iron (r=0.022, p=0.7) and negative correlation with copper (r= -0.03, p=0.50), zinc (r= -0.07, p=0.19), chromium (r= -0.05, p=0.32) and manganese (r= -0.02, p=0.63). The concentration of micronutrient in cases and controls were similar. Respondents' having micronutrients within reference values in all the participants were 372 (92.8%), 197(47.9%), 385 (96.0%), 396 (98.8%) for copper, iron, zinc and manganese respectively. This study revealed that blood levels of iron among ART and pre-ART respondents were below reference levels. Therefore iron supplementation is recommended to boost the CD4 cell counts and reduce the risk of developing anaemia both groups.