Can treatment with modern anti-HIV drugs help fight hunger for HIV-infected patients in Africa? Starting antiretroviral therapy for HIV reduces "food insecurity" among patients in Uganda, suggests a study published online by the journal AIDS, official journal of the International AIDS Society. AIDS is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
Treatment including antiretroviral therapy (ART) may lead to a "positive feedback loop" whereby improved functioning and productivity lead to increased ability to work—and thus to decreased food insecurity, according to the study by Kartika Palar, PhD and colleagues of University of California Los Angeles and RAND Corporation. The article is available on the AIDS journal homepage and in the November 28 print edition.
Food Insecurity Decreases in Year after Starting ART
The researchers studied 602 patients receiving first-time care for HIV disease at two clinics in Uganda. At one clinic, patients were started on ART, the most effective drug treatment for HIV. Patients at the other clinic were close to becoming eligible but not yet started on ART.
During the first year of treatment, the two groups were compared for changes in their level of food insecurity, defined as "the limited or uncertain availability of adequate food." Based on a simple questionnaire, about half of patients had severe food insecurity at the start of treatment (53 percent in the ART group and 46 percent of those not receiving ART).
In both groups, starting HIV treatment led to improved food security. However, the trend was more pronounced in the group receiving ART. By twelve months, the rate of severe food insecurity had decreased to 13 percent of the ART group versus 18 percent in the non-ART group.
Examination of other variables gave insight into the "pathway" by which ART may lead to improved food security. Patients starting antiretroviral drugs had greater improvements in work status and in mental health—particularly decreased scores for depression. Although physical health also improved during treatment—with or without ART—this did not seem to contribute to the reduction in food insecurity.