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Review of randomized controlled trials of nutritional supplementation in people living with HIV

Authors Snail A, Adriana Campa A, Baum M

Received 16 June 2015

Accepted for publication 5 January 2016

Published 8 April 2016 Volume 2016:8 Pages 21—39

DOI https://doi.org/10.2147/NDS.S74712

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Elizabeth Steels

Peer reviewer comments 2

Editor who approved publication: Dr Chandrika Piyathilake

Alicia Sneij, Adriana Campa, Marianna K Baum

Stempel College of Public Health and Social Work, Florida International University, Modesto Maidique Campus, Miami, FL, USA

Background: Nutritional deficiencies are widespread in people living with HIV (PLWH), prior to the antiretroviral treatment (ART). Nutrient deficiencies and other nutrition-related conditions, however, have been identified in patients receiving ART. Trials of nutritional supplementation have been conducted to alleviate these nutritional conditions and improve or reverse nutrition-related outcomes. This review aims to evaluate the benefits of supplementation, its unintended adverse effects, and the difference in approach and focus, research design, formulations, and outcomes between those randomized clinical trials (RCTs) conducted before and after the initiation of ART.
Methods: An evidence-based systematic review of the literature was conducted using electronic databases and the resources of the Florida International University Research Library. Forty-two RCTs were selected for review, and their design and outcomes were compared and contrasted conceptually and in the form of tables.
Results: Most of the RCTs (n=31) were conducted before the advent of ART, and their aims were delaying disease progression, reversing malnutrition, and improving pregnancy outcomes in women and infants infected with HIV. The RCTs conducted with coadministration of ART were fewer (n=11), with relative smaller sample size, of shorter duration, and mainly focused on preventing or ameliorating the nutrition-related conditions generated by the chronic infection, its treatment, and the aging of PLWH.
Conclusion: As ART is becoming more accessible worldwide, and people are living longer with the disease, more longitudinal trials of nutritional interventions with larger sample sizes are needed to study the nutritional consequences and potential treatments for PLWH.

Keywords: HIV, antiretroviral therapy, micronutrients, probiotics, AIDS, randomization, clinical trial

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