The effect of nutrition intervention for CD4 count improvement among mildly malnourished HIV positive men

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K00903
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Eating habits
• Research Institution: Osaka City General Hospital
• Principal Investigator: Shirano Michinori 地方独立行政法人大阪市民病院機構大阪市立総合医療センター(臨床研究センター), 臨床研究センター, 医長 (00727638)
• Co-Investigator(Kenkyū-buntansha): 羽生 大記 大阪市立大学, 大学院生活科学研究科, 教授 (40301428) ; 庄司 久美子 (加藤久美子) 女子栄養大学, 栄養学部, 助教 (50721825)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: HIV / AIDS / 低栄養 / CD4陽性リンパ球数 / CD4カウント / レプチン / CONUT

Outline of Final Research Achievements

To clarify the improvement effect of the immune response by the improvement of nutritional status, we conducted nutrition intervention for the low CD4 counts HIV-positive patients (CD4<500/μL) who are diagnosed as the mild malnutrition by CONUT. 1) Whether ingesting Ensure Liquid (250kcal) for three months will improve the CD4 counts (whether the CD4 count increase by 30% or more), 2) Whether the body fat mass and serum leptin concentration increase. We conducted a randomized controlled trial with crossover to investigate the effects of nutrition. Although nutritional addition showed a significant increase in body weight and a tendency to increase serum leptin levels, no change was observed in CD4 counts.
This is the first study to use the CONUT for nutrition evaluation of HIV-positive patients.It is necessary to examine the association of CONUT malnutrition with the change in immune response and other HIV related outcomes by a cohort study. This study will be the basic data for that.

Free Research Field

臨床感染症学

Academic Significance and Societal Importance of the Research Achievements

本研究で栄養評価に用いたCONUTは、入院患者のスクリーニングや軽度の栄養障害を抽出するのに適しているとされるが、HIV陽性者の栄養評価に用いたのは本研究が初めてであり、今後、コホート研究により、CONUT栄養不良者の免疫能の変化やその他HIVに関連したアウトカムとの関連を検討することが必要であり、本研究はそのための基礎データとなると考える。