Factors Associated With Advanced HIV and Poor Nutrition Among People Living With HIV

Human immunodeficiency virus (HIV) is an RNA virus that attacks the human body's immune system, which results, in advanced cases, in expression of opportunistic infections (1). HIV infection represents a global public health burden (2, 3). In Egypt, in 2022, about 34,000 people (<0.1%) were positive for HIV (4). There is 25-30% annual increase of newly confirmed HIV cases in Egypt over the last 10 years (5).

The WHO defines advanced HIV disease as having CD4+ T-cell count <200 cell/mm3 or having an acquired immune deficiency syndrome (AIDS)-related infection (stage 3 or 4 of HIV infection) regardless of the CD4+ T-cell count (1).

The WHO reported, in 2022, that 630,000 people living with HIV (PLWH) died from AIDS-related diseases worldwide (which is 51% fewer than those in 2010) (2, 3, 6). In Egypt, the AIDS-related deaths increased from <100 PLWH in 1990 to <1000 PLWH in 2021 (5).

PLWH are usually malnourished due to opportunistic infections, poor food intake, changes in metabolic activity or chronic illnesses. Malnutrition leads to more impairment of the immune system and further disease progression (7).

According to 2023 Global Hunger index, Egypt is at a moderate level of food insecurity, ranking 57 out of 125 countries. 14.4% of the Egyptian population are food insecure (8).

In Egypt, there is lack of data about the frequency of advanced HIV disease and the nutritional status among PLWH and associated factors. Monitoring these factors could help in early treatment of HIV infection, prevention of further virus transmission and enhancement of the nutritional pattern among PLWH.

Inclusion criteria

• (1) Newly diagnosed people living with HIV (PLWH), (2) Patients previously diagnosed with HIV but non-compliant to treatment.

Exclusion criteria

• (1) PLWH compliant on ART, (2) PLWH who refuse to participate in the study