Effect of Home Total Parenteral Nutrition on Body Composition in Patients with Acquired Immunodeficiency Syndrome

TLDR

Malnutrition is common in AIDS patients, but the effectiveness of nutritional support is unknown. The study aimed to determine the effect of prolonged total parenteral nutrition on body composition in AIDS patients. A prospective, longitudinal study of 12 AIDS patients—five with malabsorption and seven with systemic infections—measured changes in body weight, fat, and cell mass during TPN. TPN increased body weight and fat in all patients, but only those with malabsorption showed significant gains in body cell mass; patients with systemic disease had less repletion. Journal of Parenteral and Enteral Nutrition 14:454–458, 1990.

Abstract

Malnutrition occurs commonly in patients with acquired immunodeficiency syndrome (AIDS). The efficacy of nutritional support is unknown. A prospective, longitudinal study was conducted to determine the effect of prolonged total parenteral nutrition on body composition in 12 AIDS patients. Five patients were malnourished because of problems with food intake or absorption, while seven had systemic infections, with or without a malabsorption syndrome. The AIDS patients gained body weight and body fat content in response to total parenteral nutrition, while mean body cell mass, estimated as total body potassium content, was unchanged. However, all five patients with altered intake or absorption had significant repletion of body cell mass which was significantly different from the patients with systemic infections. Calorie and nitrogen intake did not differ between the two groups. It is concluded that body mass repletion is possible in AIDS patients in whom malabsorption is the major pathogenetic factor in producing malnutrition and is less successful in patients with serious ongoing systemic diseases. Thus, the response to nutritional support is dependent on the particular clinical circumstances. ( Journal of Parenteral and Enteral Nutrition 14 :454–458, 1990)