ClinNutr.Feb;35(1):-9.
Prevalenceandriskfactorsofmicronutrientdeficienciespre-andpost-antiretroviraltherapy(ART)amongadiversemulticountrycohortofHIV-infectedadults.
ShivakotiR,ChristianP,YangWT,GupteN,MwelaseN,KanyamaC,PillayS,SamanekaW,SantosB,PoongulaliS,TripathyS,RiviereC,BerendesS,LamaJR,CardosoSW,SugandhavesaP,TangAM,SembaRD,CampbellTB,GuptaA;NWCSandPEARLSStudyTeam.
DepartmentofMedicine,JohnsHopkinsUniversitySchoolofMedicine,Baltimore,MD,USA;DepartmentofInternationalHealth,JohnsHopkinsBloombergSchoolofPublicHealth,Baltimore,MD,USA;DepartmentofMedicine,UniversityofWitwatersrand,Johannesburg,,SouthAfrica;UNCLilongwe,Lilongwe,PrivateBagA-,Malawi;DurbanInternationalClinicalResearchSite,DurbanUniversityofTechnology,Durban,,SouthAfrica;UniversityofZimbabweClinicalResearchCentre,Harare,,Zimbabwe;HospitalNossaSenhoradeConcei??o,PortoAlegre,-,Brazil;YRGaitondeCenterforAIDSResearchandEducation,Chennai,,India;NationalAIDSResearchInstitute,Pune,,India;LesCentresGHESKIO,Port-Au-Prince,HT-,Haiti;MalawiCollegeofMedicine-JohnsHopkinsUniversityResearchProject,Blantyre,Malawi;AsociacionCivilImpactaSaludyEducacion,Lima,4,Peru;STD/AIDSClinicalResearchLaboratory,InstitutodePesquisaClinicaEvandroChagas,FundacaoOswaldoCruz,RiodeJaneiro,25-,Brazil;ResearchInstituteforHealthSciences,ChiangMai,50,Thailand;DepartmentofPublicHealthandCommunityMedicine,TuftsUniversitySchoolofMedicine,Boston,,MA,USA;DepartmentofOphthalmology,JohnsHopkinsUniversitySchoolofMedicine,Baltimore,,MD,USA;DepartmentofMedicine,DivisionofInfectiousDiseases,UniversityofColoradoSchoolofMedicine,Aurora,CO,,USA.
BACKGROUNDAIMS:HIV-infectedadultshaveincreasedriskofseveralindividualmicronutrientdeficiencies.However,theprevalenceandriskfactorsofconcurrentandmultiplemicronutrientdeficienciesandwhethermicronutrientconcentrationschangeafterantiretroviraltherapy(ART)initiationhavenotbeenwelldescribed.Theobjectiveofthisstudywastodeterminetheprevalenceandriskfactorsofindividual,concurrentandmultiplemicronutrientdeficienciesamongART-na?veHIV-infectedadultsfromninecountriesandassesschangeinmicronutrientstatus48weekspost-ARTinitiation.
METHODS:Arandomsub-cohort(n=)stratifiedbycountrywasselectedfromthemultinationalPEARLSclinicaltrial(n=ART-na?ve,HIV-infectedadults).WemeasuredserumconcentrationsofvitaminsA,D(25-hydroxyvitamin),E,carotenoidsandseleniumpre-ARTand48weekspost-ARTinitiation,andmeasuredvitaminsB6,B12,ferritinandsolubletransferrinreceptoratbaselineonly.Prevalenceofsinglemicronutrientdeficiencies,concurrent(2coexisting)orconditional(adeficiencyinonemicronutrientgivenadeficiencyinanother)andmultiple(≥3)weredeterminedusingdefinedserumconcentrationcutoffs.Weassessedmeanchangesinmicronutrientconcentrationsfrompre-ARTtoweek48post-ARTinitiationusingmultivariablerandomeffectsmodels.
RESULTS:Ofparticipants,13.9%,29.2%,24.5%and32.4%had0,1,2andmultipledeficiencies,respectively.Pre-ARTprevalencewasthehighestforsingledeficienciesofselenium(53.2%),vitaminD(42.4%),andB6(37.3%)with12.1%havingconcurrentdeficienciesofallthreemicronutrients.Deficiencyprevalencevariedwidelybycountry.48weekspost-ARTinitiation,meanvitaminAconcentrationincreased(p0.)correspondingtoa9%decreaseindeficiency.Meanconcentrationsalsoincreasedforothermicronutrientsassessed48weekspost-ART(p0.)butwithminimalchangeindeficiencystatus.
CONCLUSIONS:Singleandmultiplemicronutrientdeficienciesare看白癜风的医院哪比较好头上白癜风怎么治
