Association of Pre-Treatment Nutritional Status with Change in CD4 Count after Antiretroviral Therapy at 6, 12, and 24 Months in Rwandan Women 英文参考文献.docVIP

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Association of Pre-Treatment Nutritional Status with Change in CD4 Count after Antiretroviral Therapy at 6, 12, and 24 Months in Rwandan Women 英文参考文献.doc

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Association of Pre-Treatment Nutritional Status with Change in CD4 Count after Antiretroviral Therapy at 6, 12, and 24 Months in Rwandan Women 英文参考文献

AssociationofPre-TreatmentNutritionalStatuswith ChangeinCD4CountafterAntiretroviralTherapyat6, 12,and24MonthsinRwandanWomen ElizabethKiefer1,2*,DonaldR.Hoover3,QiuhuShi4,Jean-ClaudeDusingize2,MardgeCohen5 ,Eugene Mutimura6,KathrynAnastos1,2 1MontefioreMedicalCenter,Bronx,NewYork,UnitedStatesofAmerica,2AlbertEinsteinCollegeofMedicine,Bronx,NewYork,UnitedStatesofAmerica,3Institutefor Health,HealthCarePolicyandAgingResearch,RutgersUniversity,Piscataway,NewJersey,UnitedStatesofAmerica,4NewYorkMedicalCollege,Valhalla,NewYork, UnitedStatesofAmerica,5JohnStroger(formerlyCookCounty)HospitalandRushUniversity,Chicago,Illinois,UnitedStatesofAmerica,6Women’sEquityinAccessto CareandTreatment,Kigali,Rwanda Abstract Background: Body mass index (BMI) independently predicts mortality in studies of HIV infected patients initiating antiretroviraltherapy(ART).WehypothesizedthatpoorernutritionalstatuswouldbeassociatedwithsmallergainsinCD4 countinRwandanwomeninitiatingART. MethodsandFindings:TheRwandanWomen’sInterassociationStudyandAssessment,enrolled710ART-na?¨veHIV-positive and226HIV-negativewomenin2005withfollow-upevery6months.Theoutcomeassessedinthisstudywaschangein CD4countat6,12,and24monthsafterARTinitiation.NutritionalstatusmeasurestakenpriortoARTinitiationwereBMI; height adjusted fat free mass (FFMI); height adjusted fat mass (FMI), and sum of skinfold measurements. 475 women initiatedART.Mean(within6months)pre-ARTCD4countwas216cells/mL.PriortoARTinitiation,themean(6SD)BMIwas 21.6 (63.78) kg/m (18.3% malnourished with BMI,18.5); and among women for whom the following were measured, mean FFMI was 17.10 (61.76) kg/m2; FMI 4.7 (63.5) kg/m2 and sum of skinfold measurements 4.9 (62.7) cm. FFMI was significantlyassociatedwithasmallerchangeinCD4countat6monthsinunivariateanalysis(26.7cells/uLperkg/m2 ,p =0.03)only.Inmultivariateanalysisafteradjustmentforcovariates,nonutritionalvariablewasassociatedwithchangein CD4countatanyfollowupvisit. 2 Conclusion: In this cohort of African women in