Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

12th World AIDS Conference

Abstracts 42254-42369 847

42364 Nutritional statement and body composition of Mexican
children with HIV infection
Martinez Rojano Hugo1, H.L.M. Flores', G.F.E. Torres', M.G. Gutierrez1,
R.M.C. Gorbea2. 1Pediatric AIDS Clinic Infectology Hospital "La Raza" Medical
Center Mexican Institute Social Security; 2Sur 67A Prado Churubusco, 04230
Ciudad De Mexico, Mexico
Objective: To know the best indicators (antrophometric, biochemical and immunological) for evaluation of clinical statment and body composition in children
with HIV infection.
Patients and Methods: Were evaluated 34 children with HIV/AIDS infection
in any stage of infection according CDC criteria except terminal stage the range
of age was 2 to 15 years. Each patient was comparated with healthy children
in similar ages. All children was evaluated for weight, size, midle circumference
of arm, tricipital skin fold, seric albumin, nitrogen balance, transferrin, total iron,
count of red and white cells, platelets, total lymphocytes and CD4+, CD8+ count
and the relation CD4+/CD8+.
Results: Was observed statistically differences between in weight for the size,
middle circumference of arm, tricipital skind fold, seric albumin, nitrogen balance
and total CD4+, CD8+ and relation CD4/CD8. Another biochemical parameters
with statistically differences were de tranferrin and total iron in children with AIDS
when was compared whit healthy controls.
Conclusions: For optimal evaluation of nutritional condition is neccesary the
combination of differents parameters, for stablishment early nutritional interventions and disminishes the risk complications in children with AIDS.
42365 Demystifying nutrition: Micro-nutrients as food!
Lynde Francis. The Centre, 14 Harvey Brown Avenue, Harare, Zimbabwe
Issue: Scientific papers on "nutrition" usually refer to such methods as Total
Parenteral Feeding and what research has been done tends to be concerned with
"micro-nutrients" (as supplements) and not with food per se. The vast majority
of H.I.V.+ people live in the developing world where access to such treatments
is impossible but little or no effort is made to translate nutritional research into
realistic, grassroots, replicable terms.
Project: The Centre in Zimbabwe has counselled and taught basic nutritional
practice based on the local tradtional cuisine to over 600 clients since 1992.
This includes education on which foods contain which vitimins, minerals etc. and
how to prepare and present them. They have taught patients to eschew western
high-fat, low-fibre diets high in salt, sugar and stimulants and revert to foods used
prior to colonisation. The reasoning behind their recommendations i.e. sugar
feeds thrush, folic acid is needed for iron metabolism, together with the basic immunological needs of the body are explained in culturally accessible terminology.
It is important to note also that the recommended unrefined, unprocessed foods
are cheaper; the diet, therefore, is affordable.
Results: despite the exacerbating effects of severe poverty and low educational/literacy levels of many pateients, The Centre has seen fewer than 60 (10%)
deaths during the five-year period. Many clients have had little or no access to
medical interventions and have had to rely on dietry adjustment alone to maintain health. There have been numerous cases of patients with 'full-blown' AIDS
who have recovered and returned to productive health. An inreasing number
of medical practioners, having noted the beneficial effects on their pateients of
concomitant education by the The Centre's methods, are routinely referring and
over 500 pateients are maintaining a consistently asymptomatic status.
Lessons Learned: Nutrional theory can be successfully translated into replicable, affordable strategies, easily understood and achieved by sero-positive
patients in developing countries with excellent effects on overall long-term survival.
42366 Nutritional and clinical factors associated with the
progression of HIV infection in pediatric population
Maricarmen R. Gorbea1, R.H. Martinez2, H.L.M. Flores2, M.G. Gutierrez2,
G.F.E. Torres2. Pediatric AIDS Clinic Infectology Hospital "La Raza" Medical
Center, Mexican Institute Social Security; 'SUR 67A Prado Churubusco 04230,
Mexico City; 2lnfectology Hospital Mexico, Mexico
Objective: The purpose of the study was to evaluate the association between
nutritional and clinical factors with severity of infections in HIV/AIDS pediatric
patients and select the most significant ones to create a predictive model.
Patients and Methods: Fortheen patients attending to the HIV/AIDS clinic of
the infectology Hospital "La Raza" Medical Center in Mexico City were subjects of
the study. All patients were positive for HIV according CDC criteria. For purposes
of this study the patients were in stages A and B patients in terminal stage
was excluded. After the selection, measurements used for nutritional assesment
such anthropometric (weight, height, body fat skinfolds, and muscular area),
biochemical (albumin, transferrin, hemoglobin, hematocrit; nitrogen balance and
urine creatinine), immunological (total lymphocyte count T lymphocytes CD4+ and

CD8+), and functional measurements (hand grip dynamometry) was evaluated.
Results: The factors relationated with fast progression to terminal stages
in children was alteration in balance nitrogen, low levels transferrin, and low
muscular mass. The CD4+ count was not statistially significant in this study.
Conclusions: Is very important in this children the evaluation of nutritional
status for stabblishment nutritional interventions and retard to progression to
AIDS. The authors of this work will be this study for stablishment of definitive
conclusions.

42367 Load viral and body composition for electrical
bioimpedance
Rocio Alvarado-Diez1, Manuel Feregrino-Goyos2, G.C.W. Gomez3,
R.C.O. Ruiz3. 1Lago Ontario Mexico D.F. 11410; 2CITAID, Mexico D.F; 3CITAID
S.C., Mexico D.F, Mexico
Objectives: To correlation the wasted syndrome with viral load.
Design: Cross-sectional.
Methods: This study it's a part from other epidemiological study most big, and
we to included all the patients with HIV and AIDS disease, in control, with load
viral count in the moment in the study.
Results: We to analyzed 150 patients, 15% la state, 10% lb state, 30% 2a
state, 20% 2c state, 25% 3c state. The load in the la state was 30 000 copies/ml
average, and the body cellular mass was normal, r = 0.2, the same for the 1 b and
2a state, in the 2c state, the correlation was poor 0.5, however with significance
p = 0.005, the body cellular mass was 14% under normal with load viral 50 000
~ 25 000 copies/ml, but the 3c state, the body cellular mass was 30% under
normal, the load viral was 150 000 ~ 75 000 copies/ml and the correlation was
high r = 0.7, with p = 0.001.
Conclusions: In the advanced state of the disease, the waste syndrome it's a
normal condition, the bad prognostic obvious, and to exist correlation strong with
high load viral.
42368 Antioxidants enzymes level in human blood mononuclear
cells from HIV infected patients in Argentina
Diego Jones1, M.A. Taborda2, M. Taborda1, S.H. Lupo3, O.H. Fay1. 'Center of
Technology in Public Health Suipacha 531 2000 Rosario; 2CIBIC, Rosario; 3CAT
Clinmedica Hosp Prov Centenario, Rosario, Argentina
Objective: To study to response to oxidative stress testing the activities of superoxide dismutase (SOD) and Glutatione peroxidase (Gpx) in HIV patients related
to CD4/CD8 rate.
Materials and Methods: 21 patients HIV(+) were included. Mononuclear cells
isolated by Fycoll - Hypaque gradient separation; lysed by sonication; and activity
of Cu-Zn SOD (by kinetic method Ransod), Gpx (by kinetic methods Ransel) and
total proteins (TP) (Pirogallol red Randox) were tested. The CD4 and CD8 counts
were performed by flow citometry (ORTHO - D). Patients were classified in Group
1 CD4/CD8 _ 0.1 (n = 6) Group 2 0.1 < CD4/CD8 - 0.4 (n = 7) and Group 3
CD4/CD8 - 0.4 (n = 8)
Results:

SOD/TP (U/TP)
GPx/TP (U/TP)

Group 1 Group 2 Group 3 P
0.64 0.30 0.30 -0.05
0.49 1.60 1.10 0.05

Conclusions: 1) SOD/TP and GPx/TP showed significant difference among
groups (p - 0.05). 2) The increment of SOD in the group 1 could be explained by
an adaptative response induce by a higher exposure to Reactive oxygen species.
3) The low level of GPx in the same group, could be the result of an oxidative
equilibrium quantitatively different between activation and inactivation of the SOD.
More extensive study should be done in order to confirm our results.
42369 1 Community-based program on NMP for PWH/A in Jakarta
Paul Frans Matulessy', R. Nuriadi1, M. Simanjuntak', J. Lohy2, I.N.G. Moek2
F.P. Matulessy3, Soebagio4. 'JL Bangka 2C no. 31 Pela Mampang,
Palma-Medical Faculty, UKI, Jakarta; 2ESG. NH-Fkuki, Jakarta; 31MF Jakarta;
4Mintayani Foundation-Sanggar, North Jakarta, Indonesia
Issue: Implementing Nutrition Management Package (NMP) for PWH/A through
family as a part of community based program, using "SANGGAR" (Community
Lab) as a training centre activities.
Project: Using NMP approach which has 3 activities namely, Nutrition Assesment, Nutrition Intervention and Nutrition Counselling to PWH/A and family.
Strategies include the key-persons of family who look-after the food of PWH/A
using class, demonstration and practice activities. Face to face counselling and
continueing assesment of nutritional status of PWH/A was carried out in "SANGGAR" or laboratory.
Results: Continuing Nutritional Assesment will indicate the progress of PWH/A,
a well balanced diet with specific nutrients supplementation to maintain and keep
the immune system strong in PWH/A and help to minimize the symptoms commonly experienced by Nutrition counselling. Guidelines for nutrition intervention
and counselling based on Indonesian food guide and standard are tested for 10
PWH and 3 PWA.
Lessons Learned: Using Anthropometric measurement for Nutrition Assesment, Indonesian food guide for Nutrition Intervention and face-to-face counselling
as a package in Nutrition Management through the family of PWH/A are very
effective and support by the community.