Effect of Nutritional Supplementation on Illness Outcome in Adolescents with HIV on HAART: A Randomized, Double-Blind Clinical Trial

Objective To assess the effect of macronutrient and micronutrient supplementation on body mass index (BMI), hemoglobin (Hb), CD4 count, triglyceride levels, and morbidity among adolescents with human immunodeficiency virus (HIV) living in India. Methods A prospective, randomized, double-blinded, placebo-controlled trial was conducted among 80 adolescents (10-19 y) with HIV on highly active antiretroviral therapy (HAART) for a minimum of 6 mo using simple randomization. Participants in the intervention arm received 400 kcal and 15 g protein as a powder daily and multivitamin tablets thrice weekly for 3 mo. Those in the placebo arm received a similar-appearing sachet containing 100 kcal and 2 g protein daily and a placebo tablet thrice weekly. Weight, height, BMI, Hb, CD4 count, triglycerides, and number of intercurrent illnesses were measured at 3 and 6 mo. Results At 6 mo, the intervention group showed an increase in weight from 36.4 +/- 10.9 kg to 39.7 +/- 8.5 kg and a significant increase in BMI from 16.6 +/- 2.3 kg/m(2) to 17.5 +/- 2.3 kg/m(2). Increase in CD4 count in the placebo arm was more than that in the intervention arm, but the difference between the arms was not statistically significant. Intervention group showed a pronounced rise in Hb from 9.7 +/- 2.3 g/dL to 11.4 +/- 1.6 g/dL, significant reduction in triglyceride levels from 99.2 +/- 92.7 mg/dL to 81.0 +/- 12.8 mg/dL and reduction in intercurrent illnesses from 32.5% to none. Conclusions Nutritional supplementation of adolescents with HIV on HAART improves BMI, hemoglobin, and reduces triglyceride levels and intercurrent illnesses.