The reconstitution of body mass index in HIV positive subjects under antiretroviral treatment in Kinshasa

Objective: We aimed to evaluate BMI changes in HIV adults’ subjects in the first year of ART in malaria endemic areas. Methods: We used linear regression analysis showing that the change in weight at 12 months (y) in a malaria-endemic area is related to malaria infection at admission and its different episodes as illustrated by equation: y = a + bxi + ε, where x is malaria on admission, i refers to episodes of clinical malaria infection during the year, b is the slope, a is a constant and ε are confounding factors such as tuberculosis or poor eating habits. Results: We found a positive value for b (b = 0.697), and this shows that weight loss at 12 months is correlated with the diagnosis of severe malaria at admission. In other words, severe malaria eliminates the weight gained under ART. Conclusions: 1. Malaria is the leading cause of weight loss under ART. 2. Important recommendation for future: This study suggests nutritional education based on local foods containing antioxidants to fight the oxidative stress generated by HIV and stimulated by Plasmodium falciparum during febrile episodes. Oxidative stress is blocked by NADPHase which is a metalloenzyme based on selenium. Thus, to prevent a weight loss or the occurrence of the protein-energy malnutrition among people living with HIV, it is necessary to use the nutritional education.