Syndrome of depletion in HIV infection: diagnostic criteria and modern correction options

The one of leading HIV infection manifestations is trophological  insufficiency developing due to violation of digestion processes and  leading to disease progress, development of multiple organ failure and lethal outcomes.

The objective of research was to reveal the clinical and laboratory  characteristics of patients with advanced stages of HIV infection and  malnutrition, as well as the efficiency of nutritional support for this category of patients.

Materials and methods. The study included 42 patients on the  stage 4A-B HIV infection and underweight. All patients were on  inpatient treatment in the department of palliative medicine of the  St. Petersburg AIDS Center. Clinical-laboratory and instrumental  measures were analyzed, the trophic status was estimated before  the beginning of antiretroviral therapy (ART). The patients were  divided in two groups. The first group received medical enteral  nutrition (liquid mixture “Impact oral”). The second group received a  regular balanced diet. At the same time, patients in both groups  were prescribed ART in accordance with clinical guidelines.

Results. A month after the start of treatment it was possible to  analyze the results in the 1st group in 23 people and in 11 in the  2nd group. Comparative analysis showed that in the 1st group the  distribution of the patients significantly changed according to the  level of CD4 lymphocytes, BMI and nutritional status, with a  markedly positive dynamics of these indicators. Also, patients of this  group coped better with ART. Despite the fact that the analysis was  conducted at the initial stages of the work, the obtained data  demonstrate a high perspective of nutritional-metabolic therapy in  the context of optimizing the HIV treatment in patients with a  marked failure of the trophic status. 

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